Individual provider Active NPI

George F. Lasker, MD/PHD

  • Psychiatry Physician
  • Marietta, GA
National Provider Identifier
1265894265
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D89477 Issued in MD
Practice address
3921 Bays Ferry TRL
Marietta, GA 30062-5294
Phone
(770) 827-3603
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X D89477 MD Primary
General Practice Physician 208D00000X 1265894265 CA

Addresses

Primary practice location

3921 Bays Ferry TRL
Marietta, GA 30062-5294

Mailing address

600 N. Wolfe St.
Meyer 1-104
Baltimore, MD 21287
Phone (770) 827-3603

Other practice location 1

505 Parnassus Ave
Room 779 M
San Francisco, CA 94143-2204
Phone (415) 353-7500

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
I20231116001637 NY Practitioner - Psychiatry 3476982661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Tulane University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John T Mather Memorial HospitalGroup PAC ID 1254237753, shared by 6 NPIs, 176 clinicians

Practice addresses (Care Compare)

100 Highlands Blvd
Suite 201
Port Jefferson, NY 11777-2320
Phone (631) 473-3877

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

Hospital & facility affiliations

  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323555NYMDLicensed Practical Nurse
D89477MDMDPsychiatry Physician
1265894265CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital CurrentSince Oct 1, 2023 Accepting new patients
John T. Mather Memorial Hospital Psychiatry Current Accepting new patients
John T. Mather Memorial Hospital Psychiatry CurrentSince Oct 1, 2023 Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Past Accepting new patients

Locations

125 Oakland Ave
Ste 303
Port Jefferson, NY 11777
Phone (631) 729-2140

100 Highlands Blvd
#201
Port Jefferson, NY 11777
Phone (631) 473-3877

100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

Networks

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1265894265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N. WOLFE ST.",
            "address_2": "MEYER 1-104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21287",
            "telephone_number": "770-827-3603",
            "fax_number": "410-614-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 BAYS FERRY TRL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625294",
            "telephone_number": "770-827-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Parnassus Ave",
            "address_2": "Room 779 M",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432204",
            "country_code": "US",
            "telephone_number": "415-353-7500",
            "fax_number": "415-353-2889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASKER",
        "first_name": "GEORGE",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "MD/PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D89477",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "1265894265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.