Nicole K Lazzaro, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00344000 Issued in NJ

Practice address

8 Forrestal Rd S Ste 202
Princeton, NJ 08540-6658

Phone

(609) 799-6222

Fax

(609) 799-6555

NPI assigned

May 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Surgery Center of Princeton LLCGroup PAC ID 4981849825, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dermatology & Skin Surgery Center of Princeton LLC

  • MOHS-Micrographic Surgery Physician
  • Princeton, NJ
  • NPI 1386981884
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1851651889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FORRESTAL RD S STE 202",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406658",
            "telephone_number": "609-799-6222",
            "fax_number": "609-799-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FORRESTAL RD S STE 202",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406658",
            "telephone_number": "609-799-6222",
            "fax_number": "609-799-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARO",
        "first_name": "NICOLE",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014733-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00344000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Lavender, LSW
• Helen K Law, LAC
• Jennifer T. Law, LAC
• Karen Law
• Valerie Anne Layne, DNP, APN
• Thomas Allen Leach, M.D.
• Devon Leahy, LCSW
• Margarita Leahy, MA,NCC,LAC
• Jonathan David Leano, LCSW
• Alyssa Lebowitz, CCC-SLP

• Medical Physician Assistant in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.