Jerry M Lazaroff, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS-002867-L Issued in PA

Practice address

1029 N Providence Rd
Media, PA 19063-1404

Phone

(610) 566-6633

Fax

(610) 566-6637

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730169343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 N PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631404",
            "telephone_number": "610-566-6633",
            "fax_number": "610-566-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 N PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631404",
            "telephone_number": "610-566-6633",
            "fax_number": "610-566-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAROFF",
        "first_name": "JERRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-002867-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "LA1155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lawler
• Kathleen Lawlor, OTD, OTR/L
• Jesse John Lawton
• Margaret C Lazar, LCSW
• Jodi M Lazarick, OTR/L, MS
• Leading Edge Physical Therapy & Sports Medicine, Inc.
• George E Ledakis, PH.D.
• Michael Lee Jr., PT
• Cindy Barbara Lefkowitz, OTR/L
• Kathryn Lehnowsky, PA-C

• Clinical Psychologist in Media, PA
• Providers in Media, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.