Individual provider Active NPI

Gian Carlo Lazaro

  • Occupational Therapist
  • Silver Spring, MD
National Provider Identifier
1114388444
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07610 Issued in MD
Practice address
8811 Colesville Rd
Apartment 302
Silver Spring, MD 20910-4343
Phone
(443) 808-6455
NPI assigned
Mar 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 07610 MD Primary

Addresses

Primary practice location

8811 Colesville Rd
Apartment 302
Silver Spring, MD 20910-4343

Mailing address

8811 Colesville Rd
Apartment 302
Silver Spring, MD 20910-4343
Phone (443) 808-6455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220415000126 NY Practitioner - Occupational Therapist in Private Practice 0648666883 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07610MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Occupational Therapist CurrentSince Jun 1, 2023 Accepting new patients
Theradynamics Rehab. PT, OT & SLP, PLLC Occupational Therapist CurrentSince Jan 4, 2022 Accepting new patients

Locations

1811 Hone Ave
Bronx, NY 10461
Phone (516) 499-9016

280 W 231st St
Bronx, NY 10463
Phone (718) 548-1212

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

18716 Hillside Ave
Jamaica, NY 11432
Phone (718) 206-1288

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.

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1114388444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8811 COLESVILLE RD",
            "address_2": "APARTMENT 302",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104343",
            "telephone_number": "443-808-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 COLESVILLE RD",
            "address_2": "APARTMENT 302",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104343",
            "telephone_number": "443-808-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO",
        "first_name": "GIAN CARLO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.