Individual provider Active NPI

Michael Lazara

  • Physical Therapist
  • New York, NY
National Provider Identifier
1093176869
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040007 Issued in NY
Practice address
225 Broadway
New York, NY 10007-3001
Phone
(212) 732-2100
Fax
(212) 732-2105
NPI assigned
Mar 8, 2016
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040007 NY Primary

Addresses

Primary practice location

225 Broadway
New York, NY 10007-3001

Mailing address

2142 Utopia Pkwy
Whitestone, NY 11357-4142
Phone (718) 819-6803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160325000600 NY Practitioner - Physical Therapist in Private Practice 9032416623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Cynergy Physical Therapy Financial District PLLCGroup PAC ID 4284059387, 4 clinicians

Practice addresses (Care Compare)

119 W 57TH St
Suite 200
New York, NY 10019-2302
Phone (212) 292-7145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040007NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cynergy Physical Therapy Financial District PLLC Physical Therapist CurrentSince Jul 10, 2023 Accepting new patients
Miccass Physical Therapy, P.C. CurrentSince Mar 18, 2020 Accepting new patients

Locations

111 Broadway
Rm 1801
New York, NY 10006
Phone (212) 292-7145

119 W 57th St
Ste 200
New York, NY 10019
Phone (212) 292-7145

246 Columbus Ave
#C
New York, NY 10023
Phone (212) 595-4500

Networks

  • Optimum HealthCare HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1093176869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574142",
            "telephone_number": "718-819-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100073001",
            "telephone_number": "212-732-2100",
            "fax_number": "212-732-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARA",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.