Individual provider Active NPI

Marielle Bazile Lazard, M.D.

  • Cardiovascular Disease Physician
  • Orange City, FL
National Provider Identifier
1912040197
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME87805 Issued in FL
Practice address
938 Saxon Blvd
Suite 101-C
Orange City, FL 32763-8305
Phone
(386) 774-5485
Fax
(386) 775-0761
NPI assigned
Feb 15, 2007
Last updated
Dec 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME87805 FL Primary
Nuclear Cardiology Physician 207UN0901X ME87805 FL

Addresses

Primary practice location

938 Saxon Blvd
Suite 101-C
Orange City, FL 32763-8305

Mailing address

695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321
Phone (386) 258-8722

Other identifiers 2

IdentifierTypeStateIssuer
88976OtherFLBC/BS
278018600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040421000841 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789670274 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Tulane University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians
Lewis and Klancke Cardiology PAGroup PAC ID 6305731860, 13 clinicians
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709

3300 E Halifax Crossing Blvd
Deltona, FL 32725-2911
Phone (386) 425-6100

630 W Plymouth Ave
Deland, FL 32720-3260
Phone (386) 734-3654

655 N Clyde Morris Blvd
Suite C
Daytona Beach, FL 32114-2321
Phone (386) 258-8722

695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321

701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-4522

938 Saxon Blvd
Suite 101C
Orange City, FL 32763-8305
Phone (386) 774-5485

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince Jul 31, 2020 Accepting new patients
Southwest Volusia Healthcare Corporation Cardiovascular Disease CurrentSince Apr 12, 2009 Accepting new patients
Southwest Volusia Healthcare Corporation CurrentSince Apr 12, 2009 Accepting new patients
Memorial Hospital-West Volusia Inc CurrentSince May 13, 2009 Accepting new patients
Lewis & Klancke Cardiology PA Cardiovascular Disease CurrentSince Aug 1, 2007 Accepting new patients
Memorial Hospital-West Volusia Inc CurrentSince May 13, 2009 Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Dec 1, 2024 Accepting new patients
Southwest Volusia Healthcare Corporation Current Accepting new patients
Lewis & Klancke Cardiology PA Cardiovascular Disease Past Accepting new patients
Jose J Rosales MD PA Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

695 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 258-8722

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

1035 Town Center Dr
Orange City, FL 32763
Phone (386) 775-8229

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

938 Saxon Blvd
Ste 101C
Orange City, FL 32763
Phone (386) 774-5485

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 10

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.

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1912040197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142321",
            "telephone_number": "386-258-8722",
            "fax_number": "386-258-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 SAXON BLVD",
            "address_2": "SUITE 101-C",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638305",
            "telephone_number": "386-774-5485",
            "fax_number": "386-775-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARD",
        "first_name": "MARIELLE",
        "middle_name": "BAZILE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME87805",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "FL",
            "license": "ME87805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "88976",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278018600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.