Individual provider Active NPI

Andrew Alexander Lazzaro, D.C.

  • Chiropractor
  • Fairport, NY
National Provider Identifier
1952434953
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
700011418 Issued in NY
Practice address
160 Packetts LNDG
Fairport, NY 14450-1570
Phone
(585) 729-2124
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 700011418 NY Primary

Addresses

Primary practice location

160 Packetts LNDG
Fairport, NY 14450-1570

Mailing address

160 Packetts LNDG
Fairport, NY 14450-1570
Phone (585) 729-2124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000050 NY Practitioner - Chiropractic 4183718075 Reassigns benefits to 1 organization
Practice locations: Fairport, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

160 Packetts LNDG
Fairport, NY 14450-1570
Phone (585) 598-3031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011418NYMDClinical Psychologist
700011418NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Chiropractic PLLC Chiropractor CurrentSince Jun 1, 2020 Accepting new patients
Highland Hospital of Rochester PastSince May 9, 2007 Accepting new patients

Locations

160 Packetts Lndg
Fairport, NY 14450
Phone (585) 598-3031

Organizations & group practices 2

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1952434953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 PACKETTS LNDG",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501570",
            "telephone_number": "585-729-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PACKETTS LNDG",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501570",
            "telephone_number": "585-729-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARO",
        "first_name": "ANDREW",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "700011418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.