Individual provider Active NPI

Michael S Lazar, D.C.

  • Chiropractor
  • Twain Harte, CA
National Provider Identifier
1689784803
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12745 Issued in CA
Practice address
22940 Joaquin Gully Rd,
Twain Harte, CA 95383-1548
Phone
(209) 586-4441
Fax
(209) 586-4473
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12745 CA Primary

Addresses

Primary practice location

22940 Joaquin Gully Rd,
Twain Harte, CA 95383-1548

Mailing address

PO Box 1548
22940 Joaquin Gully Rd
Twain Harte, CA 95383-1548
Phone (209) 586-4441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506000820 CA Practitioner - Chiropractic 7416085717 Practice locations: Twain Harte, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1548 PO Box
Twain Harte, CA 95383

22940 Joaquin Gully Rd
Twain Harte, CA 95383-9591
Phone (209) 586-4441

PO Box
Suite 1548
Twain Harte, CA 95383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lazar Chiropractic Office Chiropractor PastSince Mar 6, 1984 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1689784803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1548",
            "address_2": "22940 JOAQUIN GULLY RD",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953831548",
            "telephone_number": "209-586-4441",
            "fax_number": "209-586-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22940 JOAQUIN GULLY RD,",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953831548",
            "telephone_number": "209-586-4441",
            "fax_number": "209-586-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "12745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twain Harte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.