Individual provider Active NPI

Lazaro N Pomeraniec, MD

  • Psychiatry Physician
  • Fairfield, CT
National Provider Identifier
1801817705
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
026040 Issued in CT
Practice address
One Post Road
Fairfield, CT 06824-6241
Phone
(203) 255-7617
Fax
(203) 255-7633
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 026040 CT Primary

Addresses

Primary practice location

One Post Road
Fairfield, CT 06824-6241

Mailing address

One Post Road
Fairfield, CT 06824-6241
Phone (203) 255-7617

Other identifiers 1

IdentifierTypeStateIssuer
001260405MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040607001498 CT Practitioner - Psychiatry 4284617770 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Mental Health LLC Psychiatry CurrentSince Apr 7, 2009 Accepting new patients
MB Care P.C. Psychiatry Past Accepting new patients
Patrick P Mastroianni MD PC Past Accepting new patients

Locations

1 Post Rd
Fairfield, CT 06824
Phone (203) 255-7617

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1801817705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE POST ROAD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246241",
            "telephone_number": "203-255-7617",
            "fax_number": "203-255-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE POST ROAD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246241",
            "telephone_number": "203-255-7617",
            "fax_number": "203-255-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMERANIEC",
        "first_name": "LAZARO",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "026040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001260405",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.