Active NPI
Gary Phillip Lask, MD
- Dermatology Physician
- Los Angeles, CA
National Provider Identifier
1275567158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- A35542
- Practice address
- 200 Medical Plaza
#450
Los Angeles, CA 90095-3075 - Phone
- (310) 825-0631
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A35542 | CA | Primary |
Addresses
Primary practice location
200 Medical Plaza
#450
Los Angeles, CA 90095-3075
Mailing address
5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 825-0631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A355420 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16260 Ventura Blvd
Suite 530
Encino, CA 91436-2285
Phone (818) 788-4022
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 605 |
| Removal of skin cancer | 29 |
| Skin biopsy | 584 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A33542 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indianer, Lask & Rosenzweig, M.D.'S, Dermatology Group, a Medical Corp | Current | Accepting new patients | |
| UCLA Medical Group | Dermatology | Past | Accepting new patients |
| Regents Univ of Calif Los Angeles | Past | Accepting new patients |
Locations
16260 Ventura Blvd
Ste 530
Encino, CA 91436
Phone (818) 788-4022
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1275567158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455632",
"telephone_number": "310-825-0631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PLAZA",
"address_2": "#450",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900953075",
"telephone_number": "310-825-0631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASK",
"first_name": "GARY",
"middle_name": "PHILLIP",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "A35542",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A355420",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.
- 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.