Individual provider Active NPI

Robert J Lazar, M.D.

  • Allergy & Immunology Physician
  • Traverse City, MI
National Provider Identifier
1831150770
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
4301050475 Issued in MI
Practice address
1115 S Union St
Traverse City, MI 49684-3258
Phone
(231) 995-3657
Fax
(231) 995-3658
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 4301050475 MI
Allergy & Immunology Physician 207K00000X 4301050475 MI Primary

Addresses

Primary practice location

1115 S Union St
Traverse City, MI 49684-3258

Mailing address

1115 S Union St
Traverse City, MI 49684-3258
Phone (231) 995-3657

Other identifiers 4

IdentifierTypeStateIssuer
110235925OtherMIRAILROAD MEDICARE
102519OtherMIPREFERED CHOICE
0280257OtherMIBCBS OF MICHIGAN
2843379MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110215000621 MI Practitioner - Allergy/Immunology 9335329846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1115 S Union St
Traverse City, MI 49684-3258
Phone (231) 955-3657

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.14 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.8

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Traverse Allergy PC Allergy CurrentSince Mar 15, 2011 Accepting new patients

Locations

3899 W Front St
Ste 1
Traverse City, MI 49684
Phone (231) 995-3657

921 W Front St
Traverse City, MI 49684
Phone (231) 252-0068

1115 S Union St
Traverse City, MI 49684
Phone (231) 935-0550

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1831150770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843258",
            "telephone_number": "231-995-3657",
            "fax_number": "231-995-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843258",
            "telephone_number": "231-995-3657",
            "fax_number": "231-995-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MI",
            "license": "4301050475",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301050475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110235925",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERED CHOICE",
            "identifier": "102519",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0280257",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2843379",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.