Individual provider Active NPI

Audrie Anne Legasto Lazaga, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1144716176
Registry record updated Oct 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
311197 Issued in NY
Practice address
506 Lenox Ave
New York, NY 10037
Phone
(212) 939-4019
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 311197 NY Primary

Addresses

Primary practice location

506 Lenox Ave
New York, NY 10037

Mailing address

506 Lenox Ave
Department of Pediatrics: MLK 17-110
New York, NY 10037-1802
Phone (212) 939-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210805000451 NY Practitioner - Pediatric Medicine 8426452905 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311197NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Feb 23, 2025 Accepting new patients
Harlem Medical Associates PC CurrentSince Apr 29, 2021 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: alazaga678225@nychhc.direct-ci.com

Organizations & group practices 4

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1144716176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 LENOX AVE",
            "address_2": "DEPARTMENT OF PEDIATRICS: MLK 17-110",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10037",
            "telephone_number": "212-939-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAGA",
        "first_name": "AUDRIE ANNE",
        "middle_name": "LEGASTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "311197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.