Individual provider Active NPI

Lory Ellen Baraz, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Phoenix, AZ
National Provider Identifier
1790780393
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25915 Issued in AZ
Practice address
3815 E Bell Rd Ste 4100
Phoenix, AZ 85032-2167
Phone
(602) 494-5040
Fax
(602) 494-4020
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25915 AZ Primary

Addresses

Primary practice location

3815 E Bell Rd Ste 4100
Phoenix, AZ 85032-2167

Mailing address

3815 E Bell Rd Ste 4500
Phoenix, AZ 85032-2171
Phone (602) 633-3838

Other identifiers 2

IdentifierTypeStateIssuer
645153MedicaidAZ
Z189045OtherAZMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100820000872 AZ Practitioner - Endocrinology 1355475658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Arizona, LLCGroup PAC ID 1052328408, 94 clinicians

Practice addresses (Care Compare)

14415 W McDowell Rd
Suite D102
Goodyear, AZ 85395-2521
Phone (623) 512-4190

3815 E Bell Rd
Suite 3200
Phoenix, AZ 85032-2162
Phone (623) 882-1292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22915AZMDClinical Social Worker
25915AZMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Arizona, LLC Internal Medicine CurrentSince May 30, 2016 Accepting new patients
Privia Medical Group Arizona, LLC CurrentSince May 30, 2016 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

10815 W McDowell Rd
Ste 304
Avondale, AZ 85392
Phone (623) 433-0155

14415 W McDowell Rd
Ste D102
Goodyear, AZ 85395
Phone (623) 512-4190

3815 E Bell Rd
Ste 4500
Phoenix, AZ 85032
Phone (602) 633-3838

3815 E Bell Rd
Ste 4100
Phoenix, AZ 85032
Phone (602) 494-5015

3815 E Bell Rd
Ste 2200
Phoenix, AZ 85032
Phone (602) 931-4689

3815 E Bell Rd
Ste 3200
Phoenix, AZ 85032
Phone (480) 840-1754

9250 N 3rd St
Ste 4010
Phoenix, AZ 85020
Phone (602) 633-3838

1301 S 7th Ave
Ste 400
Phoenix, AZ 85007
Phone (602) 824-3358

Interoperability endpoints

  • Direct secure messaging: lory.baraz.2@33227.direct.athenahealth.com

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1790780393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 4500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322171",
            "telephone_number": "602-633-3838",
            "fax_number": "602-633-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 4100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322167",
            "telephone_number": "602-494-5040",
            "fax_number": "602-494-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAZ",
        "first_name": "LORY",
        "middle_name": "ELLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AZ",
            "license": "25915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645153",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z189045",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.