Jessica Lazaro, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

020763 Issued in NY

Practice address

111 Sullivan Ave
Suite 1-6
Ferndale, NY 12734-4315

Phone

(845) 292-0890

Fax

(845) 292-0940

NPI assigned

Mar 22, 2006

Last updated

Dec 29, 2010By the provider in NPPES

Sex

Female

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

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Jefferson Medical College of Thomas Jefferson University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Physical Therapy and Wellness, PCGroup PAC ID 6800807272, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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.

• Excel Physical Therapy & Wellness, PC

  • Physical Therapist
  • Ferndale, NY
  • NPI 1265482954
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1639138191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SULLIVAN AVE",
            "address_2": "SUITE 1-6",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "127344315",
            "telephone_number": "845-292-0890",
            "fax_number": "845-292-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SULLIVAN AVE",
            "address_2": "SUITE 1-6",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "127344315",
            "telephone_number": "845-292-0890",
            "fax_number": "845-292-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prem P Gupta, MD
• Harris Anesthesia Associates PC
• Olga Isaeva, PMHNP-BC
• Jorge Ricardo Delgado, DC, PC.
• Peter Andre Kowalczyk, LCSW
• Joseph D Lazaro
• Liberty Medical Group, LLP
• Liberty Pediatrics PC
• Diane Mary Monahan, LPN BSN
• Brian Keith Mungeer, D.C.,D.A.C.N.B.

• Physical Therapist in Ferndale, NY
• Providers in Ferndale, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.