Active NPI
Justine Lazatin, DO
- Psychiatry Physician
- Brockton, MA
National Provider Identifier
1245869338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1018234
- Practice address
- 940 Belmont Street
Psychiatry 116A7
Brockton, MA 02301 - Phone
- (774) 826-2458
- Fax
- (774) 826-1859
- NPI assigned
- Apr 2, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1018234 | MA | Primary |
Addresses
Primary practice location
940 Belmont Street
Psychiatry 116A7
Brockton, MA 02301
Mailing address
1045 Baseline Rd
Grand Island, NY 14072-2511
Phone (716) 868-0377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1018234 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1245869338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 BASELINE RD",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140722511",
"telephone_number": "716-868-0377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT STREET",
"address_2": "PSYCHIATRY 116A7",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "774-826-2458",
"fax_number": "774-826-1859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZATIN",
"first_name": "JUSTINE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-02",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "1018234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.