Individual provider Active NPI

Christopher Zachary Lajudice, PA-C

  • Medical Physician Assistant
  • Williamsville, NY
National Provider Identifier
1568887933
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
325 Essjay Rd
Williamsville, NY 14221-8243
Phone
(716) 630-2600
Fax
(716) 626-1858
NPI assigned
Feb 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary
Physician Assistant 363A00000X 017403 NY

Addresses

Primary practice location

325 Essjay Rd
Williamsville, NY 14221-8243

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other practice location 1

295 Essjay Rd
Williamsville, NY 14221-8216
Phone (716) 656-4451

Other practice location 2

3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone (716) 656-4451

Other identifiers 2

IdentifierTypeStateIssuer
03809478MedicaidNY
P01620166OtherNYMEDICARE RR

Other names 1

  • Christopher Zachary Lickers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140505000935 NY Practitioner - Physician Assistant 1850524562 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.4 of 100Reported as group
Quality
72.79
Improvement activities
40
Cost
71.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017403NYMDPhysical Therapist

Organizations & group practices 3

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": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1568887933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218243",
            "telephone_number": "716-630-2600",
            "fax_number": "716-626-1858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Essjay Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142218216",
            "country_code": "US",
            "telephone_number": "716-656-4451",
            "fax_number": "716-250-5997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Buffalo St",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271842",
            "country_code": "US",
            "telephone_number": "716-656-4451",
            "fax_number": "716-250-5997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAJUDICE",
        "first_name": "CHRISTOPHER",
        "middle_name": "ZACHARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-21",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017403",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03809478",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01620166",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPHER",
            "last_name": "LICKERS",
            "middle_name": "ZACHARY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.