Active NPI
Eric Arthur Lazar, PT
- Orthopedic Physical Therapist
- Davis, CA
National Provider Identifier
1194551770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT306809
- Practice address
- 1460 Drew Ave Ste 200
Davis, CA 95618-4856 - Phone
- (530) 753-9011
- NPI assigned
- Sep 11, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT306809 | CA | Primary |
Addresses
Primary practice location
1460 Drew Ave Ste 200
Davis, CA 95618-4856
Mailing address
2033 Manet PL
Davis, CA 95618-0536
Phone (530) 758-8924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1460 Drew Ave
Suite 200
Dans, CA 95618-4856
Phone (530) 753-9011
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT306809 | CA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Edge, Inc. | Orthopedic | Current | Accepting new patients |
| Physical Edge Specialty Services | Orthopedic | Current | Accepting new patients |
Locations
1460 Drew Ave
Ste 200
Davis, CA 95618
Phone (530) 753-9011
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": "1726012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1194551770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2033 MANET PL",
"city": "DAVIS",
"state": "CA",
"postal_code": "956180536",
"telephone_number": "530-758-8924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 DREW AVE STE 200",
"city": "DAVIS",
"state": "CA",
"postal_code": "956184856",
"telephone_number": "530-753-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAR",
"first_name": "ERIC",
"middle_name": "ARTHUR",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-11",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT306809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.