Individual provider Active NPI

Matthew Dennis Lazzara, M.D.

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1720264724
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Practice address
2252 N Cleveland Ave
Apt 3F
Chicago, IL 60614-3766
Phone
(202) 498-5921
NPI assigned
Jan 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X IL Primary

Addresses

Primary practice location

2252 N Cleveland Ave
Apt 3F
Chicago, IL 60614-3766

Mailing address

2252 N Cleveland Ave
Apt 3F
Chicago, IL 60614-3766
Phone (202) 498-5921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20120824000004 MA Practitioner - Ophthalmology 6204008337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
George Washington University School of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Lexington Eye Associates, IncGroup PAC ID 5698748986, 33 clinicians
Lexington Eye Associates - BidGroup PAC ID 8820315682, 33 clinicians

Practice addresses (Care Compare)

1040 Massachusetts Ave
Arlington, MA 02476-4315
Phone (781) 648-1620

21 Worthen Rd
Lexington, MA 02421-4835
Phone (781) 862-1620

300 Baker Ave
Suite 210
Concord, MA 01742-2131
Phone (978) 369-1310

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery178

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.053316ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Eye Associates, Inc Ophthalmology CurrentSince Aug 1, 2012 Accepting new patients
Emerson Hospital Current Accepting new patients
Lexington Eye Associates - Bid Ophthalmology CurrentSince Jan 14, 2015 Accepting new patients
Lexington Eye Associates, Inc. Ophthalmology CurrentSince Aug 1, 2012 Accepting new patients

Locations

1040 Massachusetts Ave
Arlington, MA 02476
Phone (781) 648-1620

21 Worthen Rd
Lexington, MA 02421
Phone (617) 862-1620

Interoperability endpoints

  • Direct secure messaging: lazzara.matthew.epho@direct.partners.masshiway.net

Organizations & group practices 4

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": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1720264724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2252 N CLEVELAND AVE",
            "address_2": "APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143766",
            "telephone_number": "202-498-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2252 N CLEVELAND AVE",
            "address_2": "APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143766",
            "telephone_number": "202-498-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARA",
        "first_name": "MATTHEW",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.