DR. JAKE LAZAROFF (MD) – Dermatology Physician, NPI 1740654110
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
703 DERMATOLOGY in IL
Provider Addresses for DR. JAKE LAZAROFF (MD)
180 HARVESTER DR STE 110
BURR RIDGE, IL 605276686
Phone: (847) 570-4789
Type: Mailing
2650 Ridge Ave Ste 1304
Evanston, IL 602011700
Phone: (847) 570-4789
Type: Location
3783 Vogel Rd
Arnold, MO 63010
Phone: (636) 751-0995
Fax: (631) 751-0995
Type: Location
240 E Huron St
Suite 1-200
Chicago, IL 606112909
Phone: (312) 503-7975
Type: Location
PO BOX 953593
SAINT LOUIS, MO 631953593
Phone: (847) 570-4789
Type: Mailing
5841 S MARYLAND AVE # MC5067
CHICAGO, IL 606371443
Phone: (773) 702-0549
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $905.
Total Amount is formed as General ($905) + Research ($0) + Ownership ($0) = $905.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: GENZYME CORPORATION ($280).
Total Amount
$905
General + Research + Ownership
Payments
10
Total payment records
General Amount
$905
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240520002804 | I | Dermatology | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60527)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MO | |
| D E R M A T O L O G Y | MO | |
| D E R M A T O L O G Y | MO | |
| D E R M A T O L O G Y | MO | |
| D E R M A T O L O G Y | MO | |
| D E R M A T O L O G Y | MO | |
| Dermatology, Internal Medicine | MO | |
| Dermatology, Internal Medicine | MO | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | IL | |
| Dermatology, Internal Medicine | ME |
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