Active NPI
Caleb I Martinez Lazo, CAA
- Anesthesiologist Assistant
- Fayetteville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 11208
- Practice address
- 1255 Highway 54 W
Fayetteville, GA 30214-4526 - Phone
- (770) 719-7000
- NPI assigned
- Jun 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | GA | ||
| Anesthesiologist Assistant | 367H00000X | |||
| Anesthesiologist Assistant | 367H00000X | 11208 | GA | Primary |
Addresses
Primary practice location
1255 Highway 54 W
Fayetteville, GA 30214-4526
Mailing address
718 Nightwind Way
Stockbridge, GA 30281-9134
Phone (678) 978-0169
Other practice location 1
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (678) 216-0771
Other practice location 2
745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000
Other practice location 3
775 Poplar Rd Ste Ll20
Newnan, GA 30265-8306
Phone (770) 253-1912
Other practice location 4
1800 Howell Mill Rd NW Ste 250
Atlanta, GA 30318-2593
Phone (404) 537-4910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131
Hospital & facility affiliations
- Piedmont Fayette Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11208 | GA | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Anesthesia LLC | Current | Accepting new patients |
Locations
1800 Howell Mill Rd NW
Ste 250
Atlanta, GA 30318
Phone (404) 537-4910
1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754
1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222
1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911
775 Poplar Rd
Ste LL20
Newnan, GA 30265
Phone (770) 253-1912
745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785
1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Stockbridge, GA
- NPI 1700474244
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1407856594
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fayetteville, GA
- NPI 1528027240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1639809353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 NIGHTWIND WAY",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302819134",
"telephone_number": "678-978-0169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 HIGHWAY 54 W",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302144526",
"telephone_number": "770-719-7000"
}
],
"practiceLocations": [
{
"address_1": "1968 Peachtree Rd NW",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303091281",
"country_code": "US",
"telephone_number": "678-216-0771",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "745 Poplar Rd",
"address_purpose": "LOCATION",
"city": "Newnan",
"state": "GA",
"postal_code": "302651618",
"country_code": "US",
"telephone_number": "770-400-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "775 Poplar Rd Ste Ll20",
"address_purpose": "LOCATION",
"city": "Newnan",
"state": "GA",
"postal_code": "302658306",
"country_code": "US",
"telephone_number": "770-253-1912",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1800 Howell Mill Rd NW Ste 250",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303182593",
"country_code": "US",
"telephone_number": "404-537-4910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ LAZO",
"first_name": "CALEB",
"middle_name": "I",
"credential": "CAA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-15",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "11208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.