Individual provider Active NPI

Ernest Anastasios Lazos, DPM

  • Foot & Ankle Surgery Podiatrist
  • Voorhees, NJ
National Provider Identifier
1285787465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MD01805 Issued in NJ
Practice address
2301 Evesham Rd
Suite 507
Voorhees, NJ 08043
Phone
(856) 772-2979
Fax
(856) 770-1192
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X MD01805 NJ Primary

Addresses

Primary practice location

2301 Evesham Rd
Suite 507
Voorhees, NJ 08043

Mailing address

2301 Evesham Rd
Suite 507
Voorhees, NJ 08043
Phone (856) 772-2979

Other identifiers 1

IdentifierTypeStateIssuer
4787901MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD01805NJMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285787465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 EVESHAM RD",
            "address_2": "SUITE 507",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-772-2979",
            "fax_number": "856-770-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 EVESHAM RD",
            "address_2": "SUITE 507",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-772-2979",
            "fax_number": "856-770-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZOS",
        "first_name": "ERNEST",
        "middle_name": "ANASTASIOS",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD01805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4787901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.