NPIMap

Individual provider Active NPI

Stanislav Lazarev

  • Radiation Oncology Physician
  • New York, NY
National Provider Identifier
1336566272
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
298670-1 Issued in NY
Practice address
1184 5TH Avenue, First Floor
PM-124
New York, NY 10029-1002
Phone
(646) 872-9186
Fax
(212) 410-7194
NPI assigned
Mar 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Radiation Oncology Physician 2085R0001X 298670-1 NY Primary

Addresses

Primary practice location

1184 5TH Avenue, First Floor
PM-124
New York, NY 10029-1002

Mailing address

1411 E 31St St
Acmc/Highland Hospital, Dept Medicine, A2 Room 18
Oakland, CA 94602-1018
Phone (650) 518-1032

Other practice location 1

Mount Sinai Prohealth Radiation Oncology
2322 30TH Avenue
Astoria, NY 11102-1110
Phone (646) 872-9186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912001351 NY Practitioner - Radiation Oncology 0143566810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Vermont College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The New York Proton CenterGroup PAC ID 2466780218, 45 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-6500

225 E 126TH St
New York, NY 10035-1406
Phone (646) 968-9064

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
298670-1NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The New York Proton Center Radiation Oncology CurrentSince Jul 27, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

225 E 126th St
New York, NY 10035
Phone (646) 813-1880

Networks

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

Organizations & group practices 4

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 6

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1336566272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "address_2": "ACMC/HIGHLAND HOSPITAL, DEPT MEDICINE, A2 ROOM 18",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "650-518-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 5TH AVENUE, FIRST FLOOR",
            "address_2": "PM-124",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100291002",
            "telephone_number": "646-872-9186",
            "fax_number": "212-410-7194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MOUNT SINAI PROHEALTH RADIATION ONCOLOGY",
            "address_2": "2322 30TH AVENUE",
            "address_purpose": "LOCATION",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021110",
            "country_code": "US",
            "telephone_number": "646-872-9186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZAREV",
        "first_name": "STANISLAV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "298670-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.