Individual provider Active NPI

Fani Lazarova, CNP

  • Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1093275992
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN280785 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-1200
Phone
(781) 744-8000
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN280785 MA
Nurse Practitioner 363L00000X RN280785 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-1200

Mailing address

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8000

Other practice location 1

500 Salem St
Wilmington, MA 01887-1200
Phone (978) 664-1990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210830001586 MA Practitioner - Nurse Practitioner 7719382787 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN280785MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Single Specialty CurrentSince Jul 1, 2023 Accepting new patients
Lahey Clinic, Inc Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Single Specialty CurrentSince Jul 1, 2023 Accepting new patients
LGH Professional Services LLC Single Specialty Past Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. PastSince Feb 10, 2022 Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

67 S Bedford St
Ste 400
Burlington, MA 01803
Phone (781) 512-6012

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

67 S Bedford St
Ste 400E
Burlington, MA 01803

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

Organizations & group practices 7

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 6

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1093275992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018051200",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Salem St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "MA",
            "postal_code": "018871200",
            "country_code": "US",
            "telephone_number": "978-664-1990",
            "fax_number": "978-664-5028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZAROVA",
        "first_name": "FANI",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN280785",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN280785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.