NPIMap

Individual provider Active NPI

Generosa Calderon Lazor, MD

  • Pediatrics Physician
  • Bel Air, MD
National Provider Identifier
1437133014
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D34413 Issued in MD
Practice address
2014 S Tollgate Rd
Suite 200
Bel Air, MD 21015-5903
Phone
(410) 569-9533
Fax
(410) 569-1254
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D34413 MD Primary

Addresses

Primary practice location

2014 S Tollgate Rd
Suite 200
Bel Air, MD 21015-5903

Mailing address

2014 S Tollgate Rd
Suite 200
Bel Air, MD 21015-5903
Phone (410) 569-9533

Other identifiers 3

IdentifierTypeStateIssuer
408959600MedicaidMD
D34413OtherMDMD LICENSE NUMBER
293901100MedicaidMD

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

LicenseStateTypeSpecialty
D34413MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Oaks Pediatric Center, LLC Pediatrics Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1437133014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 S TOLLGATE RD",
            "address_2": "SUITE 200",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210155903",
            "telephone_number": "410-569-9533",
            "fax_number": "410-569-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 S TOLLGATE RD",
            "address_2": "SUITE 200",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210155903",
            "telephone_number": "410-569-9533",
            "fax_number": "410-569-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZOR",
        "first_name": "GENEROSA",
        "middle_name": "CALDERON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D34413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408959600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE NUMBER",
            "identifier": "D34413",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293901100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.