Domenico Lazzaro, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

01026137A Issued in OH

Practice address

701 Superior Ave
Munster, IN 46321-4037

Phone

(219) 934-2085

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Vinci Diagnostics, PC

  • Specialist
  • Munster, IN
  • NPI 1043272271
  NPD (past) Authorized official

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1487618963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463750957",
            "telephone_number": "800-756-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SUPERIOR AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214037",
            "telephone_number": "219-934-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARO",
        "first_name": "DOMENICO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "01026137A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00207505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Law, OTR/L, CLT
• Layous LLC
• Fadi Layous, MD
• Sorin Lazar, MD
• Steven H Lazaroff, CRNA
• Catherine Louise Lebryk, ATC
• Christian Sean Lee, MD
• Emmerson L Lee, DPT
• Jonathon Lee, M.D.
• Oh Jeong Lee, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Munster, IN
• Providers in Munster, IN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.