NPIMap

Individual provider Active NPI

Mark Aaron Lazarus, M.D.

  • Internal Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1902195746
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A123872 Issued in CA
Practice address
435 H St
Chula Vista, CA 91910-4307
Phone
(619) 691-7000
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0071928 CO
Internal Medicine Physician 207R00000X A123872 CA Primary

Addresses

Primary practice location

435 H St
Chula Vista, CA 91910-4307

Mailing address

1441 W Flournoy St
2F
Chicago, IL 60607-3210
Phone (847) 830-3636

Other practice location 1

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220000777 CO Practitioner - Internal Medicine 2860714326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (303) 415-7610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123872CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Mar 10, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10140 Campus Point Dr
San Diego, CA 92121
Phone (858) 678-7049

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

Interoperability endpoints

  • Direct secure messaging: mlazarus14037@scrippshlth.medalliesdirect.net

Organizations & group practices 5

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1902195746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 W FLOURNOY ST",
            "address_2": "2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073210",
            "telephone_number": "847-830-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104307",
            "telephone_number": "619-691-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4747 Arapahoe Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803031131",
            "country_code": "US",
            "telephone_number": "303-415-7610",
            "fax_number": "303-415-7610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "MARK",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0071928",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A123872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.