NPIMap

Individual provider Active NPI

Mana Behjat Sassanpour Lazzarotto, DO

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1598115677
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A16752 Issued in CA
Practice address
3555 Loma Vista Rd Ste 110
Ventura, CA 93003-3161
Phone
(805) 653-0303
NPI assigned
Jun 20, 2016
Last updated
Aug 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A16752 CA Primary

Addresses

Primary practice location

3555 Loma Vista Rd Ste 110
Ventura, CA 93003-3161

Mailing address

2772 Johnson Dr Ste 100
Ventura, CA 93003-7261
Phone (805) 642-1430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200810000656 CA Practitioner - Osteopathic Manipulative Medicine 9335564277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

2921 Saviers Rd
Oxnard, CA 93033-5314
Phone (805) 487-5588

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16752CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Feb 1, 2024 Accepting new patients
Primary Medical Group of Ventura County Inc Family Medicine CurrentSince Aug 3, 2020 Accepting new patients
Community Memorial Health System CurrentSince Feb 1, 2024 Accepting new patients
Primary Medical Group of Ventura County Inc PastSince Aug 3, 2020 Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

10885 Telegraph Rd
Ventura, CA 93004
Phone (805) 647-7704

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

2772 Johnson Dr
Ste 100
Ventura, CA 93003
Phone (805) 642-1430

2772 Johnson Dr
Ste 200
Ventura, CA 93003
Phone (805) 642-1430

3555 Loma Vista Rd
Ste 110
Ventura, CA 93003
Phone (805) 653-0303

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

Interoperability endpoints

  • Direct secure messaging: manalazzarotto@cfh.allscriptsdirect.net
  • Direct secure messaging: mlazzarotto3518190@oc.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1598115677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 JOHNSON DR STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037261",
            "telephone_number": "805-642-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 LOMA VISTA RD STE 110",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033161",
            "telephone_number": "805-653-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZAROTTO",
        "first_name": "MANA",
        "middle_name": "BEHJAT SASSANPOUR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A16752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.