Mark L Lacambra, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00042828 Issued in WA

Practice address

4915 25TH Ave NE
#301
Seattle, WA 98105-5667

Phone

(206) 368-5880

Fax

(206) 522-5236

NPI assigned

Nov 18, 2005

Last updated

Feb 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 20, 2019 through Dec 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olympic Medical Center Trust

  dba Olympic Medical Center

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1639359706
  NPD (past)
• Summit Cardiology, P.S.

  • Specialist
  • Seattle, WA
  • NPI 1205146057
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1508848953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE",
            "address_2": "#301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055667",
            "telephone_number": "206-368-5880",
            "fax_number": "206-522-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE",
            "address_2": "#301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055667",
            "telephone_number": "206-368-5880",
            "fax_number": "206-522-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAMBRA",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Labrador
• Autumn Christine Labrecque, COTA
• Daniel J Labriola, ND
• Daniel Labuda
• John Chambliss Lacambra, MD
• Robert Lacanfora, PA-C
• Alethea Dawn Lacas, M.D.
• Lynnette May Lacek, MD
• Benjamin W Lacey, MD
• June F Lacey, DA

• Family Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.