Organization Active NPI

Sean Wayne Lazarus D.P.M. LLC

  • Podiatrist
  • West Haven, CT
National Provider Identifier
1104236199
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SEAN WAYNE LAZARUS D.P.M. LLC
Practice address
764 Campelle Ave
Unitg
West Haven, CT 06516-3786
Phone
(475) 238-7400
Fax
(475) 238-7400
NPI assigned
Apr 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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

Authorized official

Name
Dr. Sean Wayne Lazarus, D.P.MNPI 1619991981
Title
Doctor
Phone
(203) 453-0704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

764 Campelle Ave
Unitg
West Haven, CT 06516-3786

Mailing address

764 Campelle Ave
Unit G
West Haven, CT 06516-3786
Phone (475) 238-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150605000259 CT Part B Supplier - Clinic/Group Practice 8921329749 Receives reassigned benefits from 1 practitioner
Practice locations: West Haven, CT
O20210623000875 CT DME Supplier - Physician - Podiatry 8921329749 Practice locations: West Haven, CT

National Provider Directory

National Provider Directory
Tax ID family
Sean Wayne Lazarus DPM LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

764 Campbell Ave
Ste G
West Haven, CT 06516
Phone (475) 238-7400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758931200000",
    "number": "1104236199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 CAMPELLE AVE",
            "address_2": "UNIT G",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163786",
            "telephone_number": "475-238-7400",
            "fax_number": "475-238-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 CAMPELLE AVE",
            "address_2": "UNITG",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163786",
            "telephone_number": "475-238-7400",
            "fax_number": "475-238-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN WAYNE LAZARUS D.P.M. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A",
        "authorized_official_last_name": "LAZARUS",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "203-453-0704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.