Individual provider Active NPI

Donato Laza, OTR

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1952504102
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11-0093 Issued in NV
Practice address
3213 W Charleston Blvd
Las Vegas, NV 89102-1962
Phone
(702) 570-6222
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11-0093 NV Primary

Addresses

Primary practice location

3213 W Charleston Blvd
Las Vegas, NV 89102-1962

Mailing address

9141 Checkerboard CT
Las Vegas, NV 89149-2999
Phone (702) 499-3764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150304000853 NV Practitioner - Physical Medicine and Rehabilitation 8325364615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Directives LLCGroup PAC ID 5799001087, 5 clinicians

Practice addresses (Care Compare)

3213 W Charleston Blvd
Suite 105
Las Vegas, NV 89102-1991
Phone (702) 570-6222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-0093NVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Directives LLC CurrentSince Jan 22, 2015 Accepting new patients

Locations

3213 W Charleston Blvd
Ste 105
Las Vegas, NV 89102
Phone (702) 570-6222

Organizations & group practices 1

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1952504102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 CHECKERBOARD CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891492999",
            "telephone_number": "702-499-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021962",
            "telephone_number": "702-570-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZA",
        "first_name": "DONATO",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "11-0093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.