Individual provider Active NPI

Shellee Rae Lazar, M.D.

  • Obstetrics & Gynecology Physician
  • Redlands, CA
National Provider Identifier
1093806382
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A66921 Issued in CA
Practice address
350 Terracina Blvd
Redlands, CA 92373-4850
Phone
(909) 335-5616
Fax
(909) 307-7518
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X A66921 CA
Obstetrics & Gynecology Physician 207V00000X A66921 CA Primary

Addresses

Primary practice location

350 Terracina Blvd
Redlands, CA 92373-4850

Mailing address

PO Box 9595
Redlands, CA 92375-2795
Phone (909) 335-5616

Other practice location 1

25485 Medical Center Dr Ste 100
Murrieta, CA 92562-6927
Phone (951) 683-6370

Other identifiers 2

IdentifierTypeStateIssuer
00A669210MedicaidCA
1467402149MedicaidCA

Other names 1

  • Shellee Rae Miyasato Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080304000496 CA Practitioner - Obstetrics/GynecologyPractitioner - Undersea and Hyperbaric Medicine 8628153442 Reassigns benefits to 4 organizations
I20161122001817 TX Practitioner - Obstetrics/Gynecology 8628153442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Undersea and Hyperbaric Medicine
Education
Loma Linda University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

350 Terracina Blvd
Redlands, CA 92373-4850
Phone (909) 335-5615

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shellee Lazar MD Apc Multi-Specialty CurrentSince Apr 7, 2024 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Multi-Specialty Current Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Multi-Specialty CurrentSince Sep 20, 2016 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc Multi-Specialty CurrentSince Sep 20, 2016 Accepting new patients
Riverside Medical Clinic, Inc Multi-Specialty Current Accepting new patients
Apex Healthcare Medical Center Inc Multi-Specialty Current Accepting new patients
Apex Healthcare Medical Center Inc Obstetrics & Gynecology CurrentSince Jun 1, 2020 Accepting new patients
Riverside Medical Clinic, Inc Multi-Specialty CurrentSince Jun 30, 2025 Accepting new patients
Riverside Medical Clinic, Inc Multi-Specialty CurrentSince Jun 30, 2025 Accepting new patients

Locations

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

1515 W Florida Ave
Hemet, CA 92543
Phone (951) 929-1333

41889 State Highway 74
Hemet, CA 92544
Phone (951) 652-8700

1225 E Latham Ave
Ste A
Hemet, CA 92543
Phone (909) 652-8700

25485 Medical Center Dr
Ste 100
Murrieta, CA 92562
Phone (909) 461-8684

25485 Medical Center Dr
Murrieta, CA 92562
Phone (951) 461-9300

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Organizations & group practices 10

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 1

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1093806382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9595",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923752795",
            "telephone_number": "909-335-5616",
            "fax_number": "909-307-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 TERRACINA BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734850",
            "telephone_number": "909-335-5616",
            "fax_number": "909-307-7518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25485 Medical Center Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925626927",
            "country_code": "US",
            "telephone_number": "951-683-6370",
            "fax_number": "951-248-6735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "SHELLEE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "CA",
            "license": "A66921",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A66921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A669210",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467402149",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEE",
            "last_name": "MIYASATO",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.