Jessica Rutstein Lazarus, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS017605 Issued in PA

Practice address

8400 Roosevelt Blvd
Suite 206
Philadelphia, PA 19152-2081

Phone

(215) 333-7562

NPI assigned

Aug 11, 2014

Last updated

Aug 11, 2014By the provider in NPPES

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 PA

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Optimal Mental Health & Wellness, PLLC

  • Adult Mental Health Clinic/Center
  • Jenkintown, PA
  • NPI 1003776295
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1942619390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 OVERHILL RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042248",
            "telephone_number": "610-405-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 ROOSEVELT BLVD",
            "address_2": "SUITE 206",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522081",
            "telephone_number": "215-333-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "JESSICA",
        "middle_name": "RUTSTEIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS017605",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017605",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bojan Lazarevic, MD
• Justin Michael Lazaroff, D.O.
• Heather Lazarow, RD
• Catherine Olivia Lazarus
• Henry Leon Lazarus, D.M. D.
• Karen Joy Lazarus, DO
• Rebecca Lazerson, DNP, APN, ACCNS-P
• Ahmed F Lazim, MD
• Brenda May Lazin, MS, RD
• Zeff Lazinger, D.C.

• Clinical Neuropsychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.