Individual provider Active NPI

Irene Mariano Lazcano, P.T.

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1710160809
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024082-1 Issued in NY
Practice address
308 Neptune Ave
Brooklyn, NY 11235-6845
Phone
(718) 615-0800
Fax
(866) 419-7618
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 024082-1 NY Primary

Addresses

Primary practice location

308 Neptune Ave
Brooklyn, NY 11235-6845

Mailing address

5852 43Rd Ave
Woodside, NY 11377-4852
Phone (718) 305-2173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024082-1NYMDPhysical Therapist
024082NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lazcano Procare Inc Past Accepting new patients
Priority One Therapy PT OT SLP PLLC PastSince Oct 1, 2022 Accepting new patients
Outcome Physical Therapy, PLLC Physical Therapist Past Accepting new patients

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": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1710160809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5852 43RD AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774852",
            "telephone_number": "718-305-2173",
            "fax_number": "718-305-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 NEPTUNE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356845",
            "telephone_number": "718-615-0800",
            "fax_number": "866-419-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZCANO",
        "first_name": "IRENE",
        "middle_name": "MARIANO",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024082-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.