Lara E Stewart, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A9455 Issued in CA

Practice address

2825 Santa Monica Blvd
Ste 301
Santa Monica, CA 90404-2429

Phone

(310) 829-3130

Fax

(310) 828-9156

NPI assigned

Jun 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Lara E Miller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lstewart576498@hisp.ehr.sutterhealth.org

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.

• Prairie Medical Group

  • Specialist
  • Marina del Rey, CA
  • NPI 1194846410
  NPD (past)
• Prairie Medical Group Inc

  • Specialist
  • Santa Monica, CA
  • NPI 1386790145
  NPD (past)
• Affinia Healthcare

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1740067719
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477559417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD",
            "address_2": "STE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-829-3130",
            "fax_number": "310-828-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD",
            "address_2": "STE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-829-3130",
            "fax_number": "310-828-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "LARA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003001210",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206087801",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "MILLER",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Stewart
• Daniel Stewart, MA,L MFT
• Edith Virginia Stewart, PH.D.
• John Michael Stewart, MD PHD
• Karen M Stewart, PSY. D
• Marnie Lynn Stewart
• Salley Anne Stewart, RNC,NP
• Sally Angela Stewart, N.P.
• John W. Stibel, O.D.
• Terri Fichman Stibel, O.D.

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.