Individual provider Active NPI

John J Lanza, MD

  • Pediatrics Physician
  • Pensacola, FL
National Provider Identifier
1508829698
Registry record updated Aug 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME50040 Issued in FL
Practice address
2315 W Jackson St
Pensacola, FL 32505-7552
Phone
(850) 436-4630
Fax
(850) 436-2095
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2020

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 ME50040 FL Primary

Addresses

Primary practice location

2315 W Jackson St
Pensacola, FL 32505-7552

Mailing address

2315 W Jackson St
Pensacola, FL 32505-7552
Phone (850) 436-4630

Other identifiers 2

IdentifierTypeStateIssuer
08899OtherFLBCBS
370453002MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091009000362 FL Practitioner - Pediatric Medicine 6608912498 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME50040FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Escambia Community Clinics Inc Current Accepting new patients
Escambia Community Clinics Inc CurrentSince Aug 15, 2020 Accepting new patients
Escambia Community Clinics, Inc CurrentSince Aug 15, 2020 Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients

Locations

470 S Highway 29
Cantonment, FL 32533
Phone (850) 780-0111

6671 Caroline St
Milton, FL 32570
Phone (850) 564-7722

5520 Stewart St
Milton, FL 32570
Phone (850) 891-9433

4435 Highway 90
Pace, FL 32571
Phone (850) 304-0390

2315 W Jackson St
Pensacola, FL 32505
Phone (850) 495-3955

2510 N 12th Ave
Pensacola, FL 32503
Phone (850) 432-7310

2500 Longleaf Dr
Bldg A
Pensacola, FL 32526
Phone (850) 665-3252

1295 W Fairfield Dr
Pensacola, FL 32501
Phone (850) 595-6417

5375 N 9th Ave
Pensacola, FL 32504
Phone (850) 760-0669

2701 N Q St
Pensacola, FL 32505
Phone (270) 791-6618

Organizations & group practices 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1508829698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W JACKSON ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325057552",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W JACKSON ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325057552",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZA",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME50040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08899",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370453002",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.