DR. JERRY M LAZAROFF (PH.D.) – Clinical Psychologist, NPI 1730169343

DR. JERRY M LAZAROFF (PH.D.) is a healthcare provider. based in Media, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PS-002867-L (PA). The NPI Number for DR. JERRY M LAZAROFF (PH.D.) is 1730169343

Main info

Male
Sole Proprietor
49 Years Of Experience
Accepts Medicare Assignment
Name
DR. JERRY M LAZAROFF (PH.D.)
NPI
1730169343
Phone
(610) 566-6633
Address
1029 N PROVIDENCE RD
Enumeration Date
19 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6105666633
Graduation Year
1977 (49 years ago)
PAC ID
6901792068
Professional Enrollment ID
I20040225000603
Address ID
PA190631404ME1029XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,668 CLINICAL PSYCHOLOGIST in PA

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Provider Addresses for DR. JERRY M LAZAROFF (PH.D.)

  • North Providence Road, Rose Tree, Media, Delaware County, Pennsylvania, 19063, United States

    MEDIA, PA 190631404

    Phone: (610) 566-6633

    Fax: (610) 566-6637

    Mailing address matches the actual address.

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: 2004-02-25

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
I20040225000603IClinical PsychologistPATBD

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
90834Psychotherapy, 45 minutes35114$0
90837Psychotherapy, 1 hour5616$0
View full utilization report →

Insurance plans in this area (ZIP 19063)

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Reviews

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Frequently asked questions

Is DR. JERRY M LAZAROFF (PH.D.) listed with a National Provider Identifier?
Yes — DR. JERRY M LAZAROFF (PH.D.) has NPI 1730169343 on file in the registry.
Is DR. JERRY M LAZAROFF (PH.D.) still an active registrant?
DR. JERRY M LAZAROFF (PH.D.) carries an active NPI according to the public dataset.
How would a patient describe DR. JERRY M LAZAROFF (PH.D.)'s focus?
For DR. JERRY M LAZAROFF (PH.D.), the primary taxonomy reads as Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. JERRY M LAZAROFF (PH.D.)?
Travel planning: use Media, Pennsylvania as the reference point for DR. JERRY M LAZAROFF (PH.D.), then confirm.
When was this NPI issued?
Enumeration for DR. JERRY M LAZAROFF (PH.D.) is noted as January 19, 2006 where the registry provides it.

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