JACK LAZERSON (NPI# 1174501985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174501985 |
| Entity Type | Individual |
| Full Name | JACK LAZERSON |
| Credential | M.D. |
| Practice Address |
1524 Pinto Ln Las Vegas NV 89106-4195 |
| Mailing Address |
2040 W Charleston Blvd 202-a Las Vegas NV 89102-2227 |
| Practice Telephone | 7026712231 |
| Practice Fax Number | 7026712233 |
| Mailing Telephone | 7026712355 |
| Mailing Fax Number | 7023825388 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2013-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 5408 | NV | Allopathic & Osteopathic Physicians |
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
5408 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | DEA | BL0765783 | 01 |
| NV | 002019718 | 05 | |
| NV | STATE PHARMACY | CS04078 | 01 |
| Street Address |
1524 PINTO LN |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699753434 | Renu Jain | Pediatrics | 1524 Pinto Ln, Las Vegas, NV 89106-4195 | 2006-01-03 |
| 1629697305 | Amy Dao | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, Las Vegas, NV 89106-4195 | 2020-04-13 |
| 1417410325 | Manisha Kaur Singh | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, Las Vegas, NV 89106-4195 | 2019-04-08 |
| 1104322338 | Gerard Holder | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, Las Vegas, NV 89106-4195 | 2018-04-05 |
| 1790212751 | Michelle Granstrom Macdavid | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, Las Vegas, NV 89106-4195 | 2017-05-21 |
| 1548796790 | Stephen Michael Smith | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, 2nd Floor, Las Vegas, NV 89106-4195 | 2017-05-10 |
| 1205367786 | Carolina Frances Koletic | Pediatrics | 1524 Pinto Ln, 2nd Floor, Las Vegas, NV 89106-4195 | 2017-03-25 |
| 1982055562 | Dania Salahuddin | Pediatrics | 1524 Pinto Ln, 2nd Floor, Las Vegas, NV 89106-4195 | 2016-06-25 |
| 1912358680 | Carlene Michelle Samuel | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, 2nd Floor, Las Vegas, NV 89106-4195 | 2016-06-23 |
| 1528418753 | Vonita Chawla | Student in an Organized Health Care Education/Training Program | 1524 Pinto Ln, Department of Pediatrics, 2nd Floor, Las Vegas, NV 89106-4195 | 2016-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669565982 | Jonathan Bernstein | Pediatrics | 12128 Montura Rosa Pl, Las Vegas, NV 89138-4554 | 2006-09-30 |
| 1740290402 | Nik F Nik Abdul Rashid | Pediatrics | 8352 W Warm Springs Rd Ste 200, Las Vegas, NV 89113 | 2006-08-08 |
| 1225440894 | Jerry Reeves | Pediatrics | 6830 W Oquendo Rd, Suite 102, Las Vegas, NV 89118-2539 | 2014-05-29 |
| 1215234356 | Daisy Catalina Cortes | Pediatrics | 8352 W Warm Springs Rd Ste 200, Las Vegas, NV 89113-3629 | 2011-02-25 |
| 1578740874 | Waseem Soud Alhushki | Pediatrics | 1 Breakthrough Way, Las Vegas, NV 89135-3011 | 2008-01-29 |
| 1700895117 | Ronald M Kline | Pediatrics | 3196 S Maryland Pkwy, Suite 400, Las Vegas, NV 89109-2305 | 2006-08-05 |
| 1124035266 | Pamela Helen-heilge Kempert | Pediatrics | 1 Breakthrough Way, Las Vegas, NV 89135-3011 | 2006-08-02 |
| 1184656613 | Kanyalakshmi Ayyanar | Pediatrics | One Breakthrough Way, Las Vegas, NV 89135 | 2006-07-07 |
| 1386680718 | Joseph L Lasky IIi | Pediatrics | 1 Breakthrough Way, Las Vegas, NV 89135-3011 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568909356 | Nevada Pediatric Hematology Oncology (hastings) PC | Pediatrics | 5301 Reno Corporate Dr, Reno, NV 89511-2381 | 2017-01-31 |
| 1417320540 | Sierra Pediatric Blood and Cancer Consortium | Pediatrics | 75 Pringle Way, Reno, NV 89502-1464 | 2015-11-11 |
| 1821317728 | Jacob P Zucker | Pediatrics | 1155 Mill St, Sierra Tower, 5th Floor, Reno, NV 89502 | 2010-05-18 |
| 1063508646 | Max Coppes | Pediatrics | 75 Pringle Way, Ste 505, Reno, NV 89502-1464 | 2006-10-04 |
| 1528177367 | James Martin Johnston | Pediatrics | 75 Pringle Way Ste 505, Reno, NV 89502-1469 | 2006-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.