NPIMap

Individual provider Active NPI

Edward Joseph Lazaga, M.D.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1396729547
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
L7950 Issued in TX
Practice address
1222 McCullough Ave
Suite 101
San Antonio, TX 78212-4812
Phone
(210) 223-4140
Fax
(210) 359-6640
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X L7950 TX Primary

Addresses

Primary practice location

1222 McCullough Ave
Suite 101
San Antonio, TX 78212-4812

Mailing address

1222 McCullough Ave
Suite 101
San Antonio, TX 78212-4812
Phone (210) 223-4140

Other identifiers 1

IdentifierTypeStateIssuer
1647927-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040608000079 TX Practitioner - NephrologyPractitioner - Internal Medicine 8921081456 Practice locations: Floresville, TX; San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1222 McCullough Ave
San Antonio, TX 78212-4812
Phone (210) 223-4140

4243 E Southcross Blvd
Suite 203
San Antonio, TX 78222-3738
Phone (210) 359-6690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
14.88 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
49.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L7950TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Treatment Services, LLC CurrentSince Mar 30, 2020 Accepting new patients
Texas Treatment Services LLC Past Accepting new patients
Kidney and Primary Care of Texas LLC Nephrology PastSince Mar 1, 2020 Accepting new patients
Micaby Medical,PLLC Nephrology PastSince Jun 1, 2020 Accepting new patients
Nephrology Associates of South Miami PA Nephrology Past Accepting new patients
Fresenius Medical Care West Bexar, LLC PastSince Nov 20, 2013 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GICECD
  • FHIR API: https://api.platform.athenahealth.com/11592/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 7

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1396729547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 MCCULLOUGH AVE",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124812",
            "telephone_number": "210-223-4140",
            "fax_number": "210-359-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 MCCULLOUGH AVE",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124812",
            "telephone_number": "210-223-4140",
            "fax_number": "210-359-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAGA",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "L7950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1647927-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.