Bryan Lazzarin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005152 Issued in MI

Practice address

30120 Harper Ave
Saint Clair Shores, MI 48082

Phone

(586) 778-7542

Fax

(586) 778-1848

NPI assigned

Jun 1, 2018

Last updated

Jul 20, 2018By 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

Medicare enrollment (NPD)

Enrolled

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.

• SVS Vision Inc

  • Optometrist
  • Saint Clair Shores, MI
  • NPI 1164557146
  NPD (past)

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1619469905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-464-1479",
            "fax_number": "586-464-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30120 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48082",
            "telephone_number": "586-778-7542",
            "fax_number": "586-778-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARIN",
        "first_name": "BRYAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Alan Larson, D.P.M.
• Shelby Larson
• Lynnette Anne Lavis, RN
• Linda Mary Lawrence, PSY.S.
• Barbara Lawson, RN MSN NPC
• Christopher Lecznar, MA LPC NCC
• Christopher L Lee, MD
• Kaylin Lee
• So Jin Lee, R.PH.
• Chelsea Lehmann, PA-C

• Optometrist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.