Look up the most recent NPI and PECOS records

Jonathan A Lazarini

Family Medicine

Allopathic & Osteopathic Physicians

1500 S Main St, Fort Worth, TX 76104-4917

PECOS Enrollment

This provider is enrolled in PECOS as JONATHAN LAZARINI.

Based on the most recent information from CMS, provider Jonathan A Lazarini is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1003102245
Provider Type
Individual
Full Name
Lazarini, Jonathan A
Credential
MD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/27/2011
Last Updated
6/30/2015

Contact Information

Practice Location

1500 S Main St, Fort Worth, TX 76104-4917

(903) 353-2265

Unlisted Fax

Mailing Location

8644 Fernhill Dr, Fort Worth, TX 76123-4015

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License P6209 Texas
Code 207PE0005X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License P6209 Texas
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License P6209 Texas

Jonathan A Lazarini

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Koch, Mark

Selzer, Kody

Nivens, Jamie Arthur

Brantly, Kent Philip

Tanna, Bhavna Nitin

Zeiser, Michael Jonathan

Walker, Thomas Lawrence

Robinson, Amber Thomas

Dr. Samuel C. Lee, Pa

Kumar, Prasanna