Active NPI
Lazau P Fougere, MD
- Family Medicine Physician
- Temple Terrace, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME122282
- Practice address
- 5503 E Busch Blvd
Temple Terrace, FL 33617-5419 - Phone
- (813) 200-7717
- Fax
- (813) 985-8500
- NPI assigned
- Jul 26, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME122282 | FL | Primary |
Addresses
Primary practice location
5503 E Busch Blvd
Temple Terrace, FL 33617-5419
Mailing address
507 W Alexander St
Plant City, FL 33563-7136
Phone (813) 754-3504
Other names 1
- Lazau P Fougere
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15320 Amberly Dr
Tampa, FL 33647-1647
Phone (813) 977-2090
2940 S US Hwy 1
Suite C11 Wellmed at Fort Pierce
Fort Pierce, FL 34982-8143
Phone (772) 466-6855
Hospital & facility affiliations
- Adventhealth Home Health
- Adventhealth Wesley Chapel
- Adventhealth Tampa
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME122282 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmed Medical Management of Florida Inc | Family Medicine | Current | Accepting new patients |
Locations
2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178
507 W Alexander St
Plant City, FL 33563
Phone (813) 754-3504
15320 Amberly Dr
Ste A
Tampa, FL 33647
Phone (813) 977-0733
8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500
Networks
- Freedom Health HMO Network
Interoperability endpoints
- lazau.fougere@wellmed.eclinicaldirectplus.com
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.
-
- Family Medicine Physician
- Port St Lucie, FL
- NPI 1033395397
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Temple Terrace, FL
- NPI 1124085238
-
- General Acute Care Hospital
- Wesley Chapel, FL
- NPI 1073893020
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1053321919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529625600000",
"number": "1699088104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 W ALEXANDER ST",
"city": "PLANT CITY",
"state": "FL",
"postal_code": "335637136",
"telephone_number": "813-754-3504",
"fax_number": "813-752-6863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5503 E BUSCH BLVD",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336175419",
"telephone_number": "813-200-7717",
"fax_number": "813-985-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUGERE",
"first_name": "LAZAU",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-26",
"last_updated": "2018-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME122282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAZAU",
"last_name": "FOUGERE",
"middle_name": "P",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Temple Terrace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.