Individual provider Active NPI

Reynaldo P Lazaro, M.D.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Oneonta, NY
National Provider Identifier
1679682256
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
124398-1 Issued in NY
Practice address
41-45 Dietz St
Oneonta, NY 13820-1855
Phone
(607) 432-8272
Fax
(607) 441-5051
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204D00000X 124398-1 NY Primary

Addresses

Primary practice location

41-45 Dietz St
Oneonta, NY 13820-1855

Mailing address

41-45 Dietz St
Oneonta, NY 13820-1855
Phone (607) 432-8272

Other identifiers 1

IdentifierTypeStateIssuer
00622940MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120117000480 NY Practitioner - Neurology 1254508120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fulton Montgomery Medical PCGroup PAC ID 1557899648, 7 clinicians

Practice addresses (Care Compare)

5010 State Hwy 30
Suite 205
Amsterdam, NY 12010-7532
Phone (518) 842-2663

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124398-1NYMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohawk Valley Orthopedics, P.C. Single Specialty CurrentSince Jul 24, 2023 Accepting new patients
Fulton Montgomery Medical PC Single Specialty CurrentSince Jan 13, 2025 Accepting new patients
Catskill Neurosciences and Radiology Assoc Single Specialty Past Accepting new patients

Locations

5010 State Highway 30
Ste 205
Amsterdam, NY 12010
Phone (518) 842-2663

434 S Kingsboro Ave
#102
Johnstown, NY 12095
Phone (518) 773-4242

Interoperability endpoints

  • Direct secure messaging: rlazaro@mohawkvalleyortho.medentdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1679682256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-45 DIETZ ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138201855",
            "telephone_number": "607-432-8272",
            "fax_number": "607-441-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41-45 DIETZ ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138201855",
            "telephone_number": "607-432-8272",
            "fax_number": "607-441-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO",
        "first_name": "REYNALDO",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "124398-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00622940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneonta, NY

Sources for this page

Verify at the official NPI Registry.