NPIMap

Individual provider Active NPI

Nicholas Tripp Lazurka, (PA-C)

  • Psychiatry Physician
  • Saginaw, MI
National Provider Identifier
1225684202
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5601009533 Issued in MI
Practice address
3085 Hallmark CT Ste 1
Saginaw, MI 48603-6803
Phone
(989) 996-0566
NPI assigned
Aug 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5601009533 MI Primary

Addresses

Primary practice location

3085 Hallmark CT Ste 1
Saginaw, MI 48603-6803

Mailing address

3283 Schust Rd Apt 206
Saginaw, MI 48603-8102
Phone (810) 304-7879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014000864 MI Practitioner - Physician Assistant 7810228426 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ausable Valley Community Mental Health Services BoardGroup PAC ID 2961485610, 16 clinicians
Bay-Arenac Behavioral HealthGroup PAC ID 5496706228, 30 clinicians
Saginaw Psychological Services IncGroup PAC ID 8426961467, 19 clinicians

Practice addresses (Care Compare)

1199 W Harris Ave
Tawas City, MI 48763-9681
Phone (989) 362-8636

201 Mulholland St
Bay City, MI 48708-7693
Phone (989) 895-2222

2100 Hemmeter Rd
Saginaw, MI 48603-3944
Phone (989) 799-2100

511 Griffin Rd
West Branch, MI 48661-9251
Phone (989) 345-5571

5805 Cedar Lake Rd
Oscoda, MI 48750-9499
Phone (989) 739-1469

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601009533MIMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: nlazurka97963@direct.covenanthealthcare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1225684202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3283 SCHUST RD APT 206",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486038102",
            "telephone_number": "810-304-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 HALLMARK CT STE 1",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486036803",
            "telephone_number": "989-996-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZURKA",
        "first_name": "NICHOLAS",
        "middle_name": "TRIPP",
        "name_prefix": "Mr.",
        "credential": "(PA-C)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5601009533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.