Matthew Watkins Lazar, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

019172 Issued in NY

Practice address

3941 50TH Ave
2ND FL
Sunnyside, NY 11104-4108

Phone

(904) 228-8611

NPI assigned

Sep 30, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida North Florida Hospital Hospital, Gainesville, FL, CCN 100204
• HCA Florida Lake City Hospital Hospital, Lake City, FL, CCN 100156
• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062
  Medicare reassignment Care Compare group
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • Family Medicine Physician
  • New York, NY
  • NPI 1760288278
  NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• North Florida Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, FL
  • NPI 1174579155
  Care Compare affiliation
• Notami Hospitals of Florida Inc

  • General Acute Care Hospital
  • Lake City, FL
  • NPI 1992751879
  Care Compare affiliation

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1144690405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 50TH AVE",
            "address_2": "2ND FL",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111044108",
            "telephone_number": "904-228-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 50TH AVE",
            "address_2": "2ND FL",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111044108",
            "telephone_number": "904-228-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "MATTHEW",
        "middle_name": "WATKINS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louiza Kubikian, D.D.S.
• Rebecca Kucker, MSW
• Priyanka Kumari, PHARMD
• Jocelyn Fae Kupperman, M.S., CCC- SLP
• Loredana Ladogana, MD
• Aena Lee
• Caroline G Lee, PT
• Eunnie Michelle Lee, LMSW
• Hyun Min Lee, MSED
• Lai Y Lee

• Physician Assistant in Sunnyside, NY
• Providers in Sunnyside, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.