Individual provider Active NPI

Robert Michael Lazar, MD

  • Gastroenterology Physician
  • Commack, NY
National Provider Identifier
1730164179
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
153441 Issued in NY
Practice address
1092 Jericho Tpke Ste 2S
Commack, NY 11725-3016
Phone
(631) 543-8660
Fax
(631) 543-8661
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 153441 NY Primary

Addresses

Primary practice location

1092 Jericho Tpke Ste 2S
Commack, NY 11725-3016

Mailing address

1092 Jericho Tpke Ste 2S
Commack, NY 11725-3016
Phone (631) 543-8660

Other identifiers 10

IdentifierTypeStateIssuer
2593739OtherGHI
71232OtherGHI (HMO)
29866OtherAETNA / US HEALTHCARE
31048OtherVYTRA
AA50365OtherMDNY
0001755OtherIND. HEALTH
0270298OtherNYCIGNA
CS317OtherOXFORD
4C3299OtherHEALTHNET
3V6281OtherNYBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080201000046 NY Practitioner - Gastroenterology 8729088125 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Endoscopy, PC Gastroenterology CurrentSince Feb 6, 2022 Accepting new patients
Robert M Lazar MD PC Gastroenterology CurrentSince Nov 21, 2002 Accepting new patients
CHS Physician Partners, P.C Past Accepting new patients

Locations

1092 Jericho Tpke
Ste 2S
Commack, NY 11725
Phone (631) 543-8660

48 Route 25A
Ste 107
Smithtown, NY 11787
Phone (631) 862-3680

989 W Jericho Tpke
Smithtown, NY 11787
Phone (631) 864-5600

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1730164179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 JERICHO TPKE STE 2S",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253016",
            "telephone_number": "631-543-8660",
            "fax_number": "631-543-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 JERICHO TPKE STE 2S",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253016",
            "telephone_number": "631-543-8660",
            "fax_number": "631-543-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "153441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2593739",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI (HMO)",
            "identifier": "71232",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA / US HEALTHCARE",
            "identifier": "29866",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "31048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AA50365",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND. HEALTH",
            "identifier": "0001755",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0270298",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "CS317",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "4C3299",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "3V6281",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.