Individual provider Active NPI

Mark H Lazar, M.D.

  • Neurology Physician
  • East Brunswick, NJ
National Provider Identifier
1679639850
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
42290 Issued in NJ
Practice address
573 Cranbury Rd
A5
East Brunswick, NJ 08816-4026
Phone
(732) 254-5101
Fax
(732) 254-2640
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 42290 NJ Primary

Addresses

Primary practice location

573 Cranbury Rd
A5
East Brunswick, NJ 08816-4026

Mailing address

573 Cranbury Rd
A5
East Brunswick, NJ 08816-4026
Phone (732) 254-5101

Other identifiers 2

IdentifierTypeStateIssuer
4245241OtherNJAETNA PIN
50389OtherNJEMPIRE BC BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110317000157 NJ Practitioner - Neurology 8729260401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

573 Cranbury Rd
East Brunswick, NJ 08816-4144
Phone (732) 254-5101

Hospital & facility affiliations

  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42290NJMDNeurology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1679639850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "573 CRANBURY RD",
            "address_2": "A5",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164026",
            "telephone_number": "732-254-5101",
            "fax_number": "732-254-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 CRANBURY RD",
            "address_2": "A5",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164026",
            "telephone_number": "732-254-5101",
            "fax_number": "732-254-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "42290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "4245241",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "50389",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.