NPIMap

Organization Active NPI

D S Lazar DPM PC

  • Podiatrist
  • Oak Park, MI
National Provider Identifier
1306077086
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001114 Issued in MI
Legal business name
D S LAZAR DPM PC
Practice address
15300 W 9 Mile Rd
Suite 2
Oak Park, MI 48237-2584
Phone
(248) 967-3668
Fax
(248) 967-0630
NPI assigned
Jul 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
D S Lazar, DPM
Title
Owner
Phone
(248) 967-3668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901001114 MI Primary

Addresses

Primary practice location

15300 W 9 Mile Rd
Suite 2
Oak Park, MI 48237-2584

Mailing address

15300 W 9 Mile Rd
Suite 2
Oak Park, MI 48237-2584
Phone (248) 967-3668

Other identifiers 2

IdentifierTypeStateIssuer
1502974MedicaidMI
P00067283OtherMIMEDICARE RAILROAD INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110118000171 MI Part B Supplier - Clinic/Group Practice 9739378126 Receives reassigned benefits from 1 practitioner
Practice locations: Waterford, MI

National Provider Directory

National Provider Directory

Locations

26106 Greenfield Rd
Ste A
Oak Park, MI 48237
Phone (248) 569-1395

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1306077086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 W 9 MILE RD",
            "address_2": "SUITE 2",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372584",
            "telephone_number": "248-967-3668",
            "fax_number": "248-967-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 W 9 MILE RD",
            "address_2": "SUITE 2",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372584",
            "telephone_number": "248-967-3668",
            "fax_number": "248-967-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D S LAZAR DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "LAZAR",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-967-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1502974",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD INSURANCE",
            "identifier": "P00067283",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.