NPIMap

Individual provider Active NPI

Jessica Lazar, MD

  • Family Medicine Physician
  • Kenai, AK
National Provider Identifier
1407387186
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
165745 Issued in AK
Practice address
506 Lake St
Kenai, AK 99611-6937
Phone
(907) 714-4025
Fax
(844) 412-3952
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 165745 AK Primary

Addresses

Primary practice location

506 Lake St
Kenai, AK 99611-6937

Mailing address

903 32ND Ave E
Seattle, WA 98112-3702

Other practice location 1

903 32nd Ave E
Seattle, WA 98112-3702
Phone (907) 947-6430

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlazar570514@ak.providencedirect.org

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
I20230124000247 TX Practitioner - Family Practice 9638589419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcentral FoundationGroup PAC ID 5496663627, 168 clinicians
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone (907) 265-4955

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation Single Specialty Current Accepting new patients
Southcentral Foundation Single Specialty Current Accepting new patients
Southcentral Foundation Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Southcentral Foundation Single Specialty Current Accepting new patients
Southcentral Foundation Single Specialty Current Accepting new patients
Southcentral Foundation Single Specialty Current Accepting new patients
Alaska Native Tribal Health Consortium Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Southcentral Foundation Single Specialty Current Accepting new patients
Southcentral Foundation Single Specialty Current Accepting new patients
Southcentral Foundation Single Specialty Past Accepting new patients
Southcentral Foundation Single Specialty Past Accepting new patients

Locations

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

Organizations & group practices 11

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1407387186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 32ND AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LAKE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116937",
            "telephone_number": "907-714-4025",
            "fax_number": "844-412-3952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 32nd Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981123702",
            "country_code": "US",
            "telephone_number": "907-947-6430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "165745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlazar570514@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "Provider direct messaging address",
            "address_1": "506 Lake St",
            "city": "Kenai",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996116937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

Verify at the official NPI Registry.