Active NPI
Richard Lazaroff, M.D.
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1407837289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R3A04
- Practice address
- 11630 Studt Ave
Saint Louis, MO 63141-7016 - Phone
- (314) 567-7337
- Fax
- (314) 851-4476
- NPI assigned
- Nov 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R3A04 | MO | Primary |
Addresses
Primary practice location
11630 Studt Ave
Saint Louis, MO 63141-7016
Mailing address
PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 567-7337
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1822V34311 | Other | MO | HEALTHCARE USA |
| 100893 | Other | MO | HEALTHLINK |
| 1200169 | Other | MO | UHC |
| 39959 | Other | MO | GHP |
| 19913 | Other | MO | BCBS |
| 400600 | Other | MO | AETNA |
| A13900 | Other | MO | MERCY |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3A04 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1407837289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23340",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631563340",
"telephone_number": "314-567-7337",
"fax_number": "314-851-4476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11630 STUDT AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417016",
"telephone_number": "314-567-7337",
"fax_number": "314-851-4476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAROFF",
"first_name": "RICHARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R3A04",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA",
"identifier": "1822V34311",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "100893",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "1200169",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "39959",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "19913",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "400600",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "A13900",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.