Individual provider Active NPI

Alicia Harrison Lazeski, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
National Provider Identifier
1689965162
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2015-01567 Issued in NC
Practice address
15825 Ballantyne Medical PL Ste 100
Charlotte, NC 28277-0745
Phone
(704) 323-3400
NPI assigned
May 2, 2011
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2015-01567 NC Primary

Addresses

Primary practice location

15825 Ballantyne Medical PL Ste 100
Charlotte, NC 28277-0745

Mailing address

4601 Park Rd
Suite 250
Charlotte, NC 28209-3239
Phone (704) 323-2000

Other identifiers 1

IdentifierTypeStateIssuer
1689965162MedicaidNC

Other names 1

  • Dr. Alicia Lynne Harrison Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150926000082 NC Practitioner - Physical Medicine and Rehabilitation 9133437072 Reassigns benefits to 1 organization
I20180125001386 SC Practitioner - Pain Management 9133437072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
State University of Ny Upstate Medical University, 2011
Medicare assignment
May accept Medicare assignment
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

15825 Ballantyne Medical PL
Suite 100
Charlotte, NC 28277-4652
Phone (704) 542-1901

2536 Lengers Way
Fort Mill, SC 29707-7126
Phone (803) 313-3294

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

601 Sutton Rd S
Fort Mill, SC 29715-8439
Phone (803) 328-6306

6237 Carolina Commons Dr
Suite 110
Indian Land, SC 29707-6014
Phone (803) 266-7547

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina, PA CurrentSince Jul 27, 2015 Accepting new patients
Orthocarolina CurrentSince Dec 3, 2017 Accepting new patients
Orthocarolina CurrentSince Jul 27, 2015 Accepting new patients
Orthocarolina Past Accepting new patients

Locations

15825 Ballantyne Medical Pl
Ste 100
Charlotte, NC 28277
Phone (704) 323-3400

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

601 Sutton Rd S
Ste 101
Fort Mill, SC 29715
Phone (803) 328-6303

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1689965162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 BALLANTYNE MEDICAL PL STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770745",
            "telephone_number": "704-323-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZESKI",
        "first_name": "ALICIA",
        "middle_name": "HARRISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2015-01567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689965162",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "HARRISON",
            "middle_name": "LYNNE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.