Dr. Nicole Lynn Lacz
Radiology (Diagnostic Radiology)

Address: 20 High St, Nutley, NJ 07110-1132
Phone: 9738793964

Dr. Nicole Lynn Lacz (NPI# 1306052246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1306052246
Entity Type Individual
Full Name Dr. Nicole Lynn Lacz
Credential M.D.
Gender Female
Practice Address 20 High St
Nutley
NJ 07110-1132
Practice Telephone 9738793964
Practice Fax Number 9732840269
Mailing Address 777 Passaic Ave
Ste 360
Clifton
NJ 07012-1800
Mailing Telephone 9732840020
Mailing Fax Number 9732846310
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2007-05-15
Last Update Date 2017-01-19

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 2085R0202X Radiology · Diagnostic Radiology Allopathic & Osteopathic Physicians 25MA08793500 NJ

Physician Overview

NPI 1306052246
PAC ID by PECOS 1153599055
Professional Enrollment ID I20110720000451
Full Name Nicole L Lacz
Organization Legal Name MONTCLAIR RADIOLOGICAL ASSOC PA
Phone Number 9737462525
Gender F
Medical School UMDNJ-NEW JERSEY MEDICAL SCHOOL
Graduation Year 2004
Primary Specialty DIAGNOSTIC RADIOLOGY
Group Practice PAC ID 3274507447
Number of Group Practice Members 15
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
310017 CHILTON MEDICAL CENTER
310015 MORRISTOWN MEDICAL CENTER
310019 ST JOSEPH'S HOSPITAL AND MEDICAL CENTER

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_225_1 Radiology: Reminder System for Screening Mammograms 1%

Office Location

Street Address 20 HIGH ST
City NUTLEY
State NJ
Zip Code 07110-1132

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235143504 Sarah A Dodge Radiology 20 High St, Nutley, NJ 07110-1132 2006-07-29
1457669004 Konstantin Krepkin Radiology 20 High St, Nutley, NJ 07110-1132 2010-09-16
1588829204 Ross Mondshine Radiology 20 High St, Nutley, NJ 07110 2008-07-22
1295909190 Lisa Taub Bash Radiology 20 High St, Nutley, NJ 07110-1132 2008-04-22
1669513099 Jessica Torrente Radiology 20 High St, Nutley, NJ 07110-1132 2007-02-09
1588701213 Brett D Ferdinand Radiology 20 High St, Nutley, NJ 07110-1132 2007-01-31
1285796474 Anuj J Tolia Radiology 20 High St, Nutley, NJ 07110 2006-12-14
1639267156 Daniel Levy Radiology 20 High St, Nutley, NJ 07110-1132 2006-10-10
1063508588 Denise C Mcfadden Radiology 20 High St, Nutley, NJ 07110-1132 2006-10-04
1194810531 Montclair Radiological Assoc,pa Radiology 20 High St, Nutley, NJ 07110 2006-10-03
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548762073 Michal Milow Divney Social Worker 340 Kingsland St Bldg 123, Nutley, NJ 07110 2018-02-28
1144743162 Erin Doyle Theodorou Counselor 29 Faber Pl, Nutley, NJ 07110 2017-07-21
1134642671 Everas Community Services, Inc. Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 150 Kingsland St, Nutley, NJ 07110 2017-07-17
1851811764 Janet Joke Bamgbade Social Worker 21 River Road, Apt. J, Nutley, NJ 07110 2017-06-21
1588190656 Nutley Vision Eyewear Supplier 214 Franklin Ave., Nutley, NJ 07110 2017-05-10
1043662596 Angela Furnari Social Worker 596 Franklin Ave, Nutley, NJ 07110 2016-07-08
1659720381 Nutley Adult Day Care Inc Clinic/Center 357-361 Harrison St, 1st Floor, Nutley, NJ 07110 2016-06-03
1881055937 Roman Rubin Community/Behavioral Health 263 Hillside Address, 5, Nutley, NJ 07110 2016-03-17
1275937922 Victoria L Beckerman Social Worker 405 Centre St, Nutley, NJ 07110 2014-10-09
1114277423 Lisa Marie Riccardelli Social Worker 562 Kingsland Street, Nutley, NJ 07110 2012-09-13
Find all providers in zip 07110

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982713681 Steven D Richman Radiology 20 High Street, Nutley, NJ 07110 2006-08-29
1013023423 Mona Khedkar Radiology 410 Centre St, Nutley, NJ 07110-1635 2006-08-21
1235143504 Sarah A Dodge Radiology 20 High St, Nutley, NJ 07110-1132 2006-07-29
1457669004 Konstantin Krepkin Radiology 20 High St, Nutley, NJ 07110-1132 2010-09-16
1588829204 Ross Mondshine Radiology 20 High St, Nutley, NJ 07110 2008-07-22
1295909190 Lisa Taub Bash Radiology 20 High St, Nutley, NJ 07110-1132 2008-04-22
1669513099 Jessica Torrente Radiology 20 High St, Nutley, NJ 07110-1132 2007-02-09
1588701213 Brett D Ferdinand Radiology 20 High St, Nutley, NJ 07110-1132 2007-01-31
1285796474 Anuj J Tolia Radiology 20 High St, Nutley, NJ 07110 2006-12-14
1639267156 Daniel Levy Radiology 20 High St, Nutley, NJ 07110-1132 2006-10-10
Find all providers in NUTLEY

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City NUTLEY
Zip Code 07110

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Dataset Information

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.

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