Individual provider Active NPI

Ronald M. Lazar, PH.D.

  • Clinical Neuropsychologist
  • New York, NY
National Provider Identifier
1851483408
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7023 Issued in NY
Practice address
710 W 168TH Street
New York, NY 10032-2699
Phone
(212) 305-4749
Fax
(212) 305-3741
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7023 NY Primary

Addresses

Primary practice location

710 W 168TH Street
New York, NY 10032-2699

Mailing address

710 W 168TH Street
New York, NY 10032-2699
Phone (212) 305-4749

Other identifiers 1

IdentifierTypeStateIssuer
01622155MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20190419000782 AL Practitioner - Clinical Psychologist 0749305704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35246-0001
Phone (205) 934-3460

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007023NYMDMental Health Counselor
7023NYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Apr 1, 2019 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

Interoperability endpoints

  • Direct secure messaging: rlazar@direct.uabmedicine.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1851483408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322699",
            "telephone_number": "212-305-4749",
            "fax_number": "212-305-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322699",
            "telephone_number": "212-305-4749",
            "fax_number": "212-305-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "RONALD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "7023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01622155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.