Individual provider Active NPI

Bruce R Lasker, MD

  • Neurology Physician
  • San Diego, CA
National Provider Identifier
1043299399
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A54791 Issued in CA
Practice address
3737 Moraga Ave
Suite a-5
San Diego, CA 92117-5404
Phone
(858) 273-3300
Fax
(858) 273-5736
NPI assigned
Jan 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A54791 CA Primary

Addresses

Primary practice location

3737 Moraga Ave
Suite a-5
San Diego, CA 92117-5404

Mailing address

3737 Moraga Ave Ste A5
San Diego, CA 92117-5459
Phone (858) 273-3300

Other identifiers 1

IdentifierTypeStateIssuer
00G547910MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041210000838 CA Practitioner - Neurology 1658337753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Northwestern University Feinberg Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3737 Moraga Ave
Suite A5
San Diego, CA 92117-5459
Phone (858) 273-3300

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A54791CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Pacific Neurology AMC Neurology CurrentSince Jan 2, 2004 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

3652 Eureka Way
Redding, CA 96001
Phone (530) 243-6811

3737 Moraga Ave
Ste A1
San Diego, CA 92117
Phone (619) 273-3300

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

3737 Moraga Ave
Ste A5
San Diego, CA 92117
Phone (858) 272-8215

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: blasker81238@scrippshlth.medalliesdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1043299399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE A5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175459",
            "telephone_number": "858-273-3300",
            "fax_number": "858-273-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "SUITE A-5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175404",
            "telephone_number": "858-273-3300",
            "fax_number": "858-273-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKER",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-14",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A54791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G547910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.