Individual provider Active NPI

Ricardo Lazaro Pascual, DDS

  • Periodontics
  • Boston, MA
National Provider Identifier
1043863533
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
7772 Issued in ZZ
Practice address
1 Kneeland St Dept
Boston, MA 02111-1527
Phone
(617) 372-1143
NPI assigned
Jul 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 7772 ZZ Primary

Addresses

Primary practice location

1 Kneeland St Dept
Boston, MA 02111-1527

Mailing address

665 Washington St Unit 1203
Boston, MA 02111-1644
Phone (617) 372-1143

Other practice location 1

1 Kneeland St Dept 12th
Boston, MA 02111-1527
Phone (617) 372-1143

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ricardo.lazaro@tufts.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7772ZZMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1043863533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 WASHINGTON ST UNIT 1203",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111644",
            "telephone_number": "617-372-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST DEPT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-372-1143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kneeland St Dept 12th",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111527",
            "country_code": "US",
            "telephone_number": "617-372-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZARO PASCUAL",
        "first_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ZZ",
            "license": "7772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ricardo.lazaro@tufts.edu",
            "affiliation": "N",
            "address_1": "1 Kneeland St Dept 12th",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021111527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.