Individual provider Active NPI

Dariusz A Lazarczyk, MD

  • Gastroenterology Physician
  • Troy, MI
National Provider Identifier
1083603500
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
063367 Issued in MI
Practice address
264 W Maple Rd
#200
Troy, MI 48084-5435
Phone
(248) 273-9930
Fax
(248) 273-9931
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 063367 MI Primary

Addresses

Primary practice location

264 W Maple Rd
#200
Troy, MI 48084-5435

Mailing address

264 W Maple Rd
#200
Troy, MI 48084-5435
Phone (248) 273-9930

Other identifiers 1

IdentifierTypeStateIssuer
4163102MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dlazarczyk353531@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101208000700 MI Practitioner - Gastroenterology 8729984109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Specialists PCGroup PAC ID 4880590264, 16 clinicians

Practice addresses (Care Compare)

264 W Maple Rd
Suite 200
Troy, MI 48084-5458
Phone (248) 273-9930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
83.02

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy97
Upper gastrointestinal (GI) endoscopy for acid reflux127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
063367MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Specialists PC Gastroenterology CurrentSince Jan 27, 2000 Accepting new patients
Essential Anesthesia Services, PLC PastSince Mar 1, 2012 Accepting new patients

Locations

3601 W 13 Mile Rd
Royal Oak, MI 48073

264 W Maple Rd
Ste 200
Troy, MI 48084
Phone (248) 273-9930

Interoperability endpoints

  • Direct secure messaging: dlazarczyk1243258@epic00.shdirect.org

Organizations & group practices 2

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1083603500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 W MAPLE RD",
            "address_2": "#200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845435",
            "telephone_number": "248-273-9930",
            "fax_number": "248-273-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 W MAPLE RD",
            "address_2": "#200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845435",
            "telephone_number": "248-273-9930",
            "fax_number": "248-273-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARCZYK",
        "first_name": "DARIUSZ",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "063367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4163102",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlazarczyk353531@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "264 W Maple Rd",
            "address_2": "#200",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480845435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.