Lauren Washatka, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

70506 Issued in AZ

Practice address

806 S Ponderosa St
Payson, AZ 85541-5541

Phone

(928) 468-8603

NPI assigned

Apr 16, 2019

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lauren Dominick Former name

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

Specialty

Internal Medicine

Education

University of Arizona College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ponderosa Family Care LLCGroup PAC ID 1456548015, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Home Care - Payson Home health agency, Payson, AZ, CCN 037114
• Banner Payson Medical Center Hospital, Payson, AZ, CCN 031318

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CEIBDA

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Chelani Productions, LLC

  dba Gabbert Medical

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1417768110

  W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ponderosa Family Care, LLC

  • Internal Medicine Physician
  • Payson, AZ
  • NPI 1144535626
  Medicare reassignment Care Compare group NPD
• Chelani Productions, LLC

  dba Gabbert Medical

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1417768110

  Family Medicine

  Medicare reassignment NPD
• Ponderosa Family Care, LLC

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1992321723
  NPD
• Regenthetics, LLC

  • Pain Clinic/Center
  • Payson, AZ
  • NPI 1932717550
  NPD
• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  Care Compare affiliation
• Banner Home Care-Arizona

  • Home Health Agency
  • Phoenix, AZ
  • NPI 1568844181
  Care Compare affiliation

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1821651746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 S PONDEROSA ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415541",
            "telephone_number": "928-468-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 S PONDEROSA ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415541",
            "telephone_number": "928-468-8603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 S Ponderosa St",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855415542",
            "country_code": "US",
            "telephone_number": "928-471-3222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASHATKA",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "70506",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "70506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "DOMINICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Melissa Wade, D.M.D.
• Frank Edward Waechter III, MD
• Walgreen Co (Walgreens #06533)
• Walmart Inc. (Walmart Pharmacy 10-1369)
• Walmart Stores, Inc. (Vision Center 30-1369)
• Karen M. Waters
• Chandra Wattleworth
• Karl Watts
• Mark Westberg, PHARM D.
• Jaegar Dean White, MD

• Internal Medicine Physician in Payson, AZ
• Providers in Payson, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.