IVAN EDUARDO LIZARAZO (MD) – Family Medicine Physician, NPI 1730337122

IVAN EDUARDO LIZARAZO (MD) is a healthcare provider. based in Belfast, Maine. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 125053776 (IL). The NPI Number for IVAN EDUARDO LIZARAZO (MD) is 1730337122

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
IVAN EDUARDO LIZARAZO (MD)
NPI
1730337122
Phone
(216) 896-1800
Address
PO BOX 8792
Enumeration Date
28 August 2008
Last Update Date
11 August 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5614257801
Graduation Year
2002 (24 years ago)
PAC ID
2062537053
Group Practice PAC ID
0941456537
Professional Enrollment ID
I20120118000650
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:17State licenses:2Digital endpointsOther names

Provider Addresses for IVAN EDUARDO LIZARAZO (MD)

  • PO BOX 8792

    BELFAST, ME 049158792

    Phone: (216) 896-1800

    Fax: (216) 896-1801

    Type: Mailing

  • 3909 ORANGE PL STE 2100

    BEACHWOOD, OH 441228400

    Phone: (216) 896-1800

    Fax: (216) 896-1801

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2012-01-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120118000650IFamily PracticeFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2218$0
G0442Annual alcohol misuse screening, 5 to 15 minutes1616$0
View full utilization report →

Insurance plans in this area (ZIP 04915)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941456537View full group profile
NameSpecialtyState
Family Practice, Sports MedicineFL
-FL
Nurse PractitionerFL
Physician AssistantFL
Nurse PractitionerFL
-FL
Family PracticeFL
-NC
Physician AssistantFL
Nurse PractitionerTN

Reviews

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Frequently asked questions

What NPI should I save for IVAN EDUARDO LIZARAZO (MD)?
Save NPI 1730337122 if you need a stable reference for IVAN EDUARDO LIZARAZO (MD).
Is IVAN EDUARDO LIZARAZO (MD) active in the national directory?
IVAN EDUARDO LIZARAZO (MD)'s public NPI profile is in an active state.
What kind of provider is IVAN EDUARDO LIZARAZO (MD)?
The page reflects Family Medicine Physician for IVAN EDUARDO LIZARAZO (MD). Clinical services aligned with this taxonomy classification.
What location shows for IVAN EDUARDO LIZARAZO (MD)?
We surface Belfast, Maine for IVAN EDUARDO LIZARAZO (MD) based on available NPPES addresses.
What if Belfast, Maine seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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