SAMARA D. LAZERNICK (MD) – Obstetrics & Gynecology Physician, NPI 1659532307
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
358 OBSTETRICS/GYNECOLOGY in UT
Provider Addresses for SAMARA D. LAZERNICK (MD)
196 E. 2000 N.
SUITE 104
TOOELE, UT 84074
Phone: (435) 843-2576
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)
CMS reports 9 Open Payments records for all available years, with a total value of $154.
Total Amount is formed as General ($154) + Research ($0) + Ownership ($0) = $154.
Last reported payment date: 2024-12-07 • Largest payer in this snapshot: Organon LLC ($32).
Total Amount
$154
General + Research + Ownership
Payments
9
Total payment records
General Amount
$154
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organon LLC | $32 |
| Applied Medical Resources Corporation | $27 |
| Axonics, Inc. | $25 |
| Agile Therapeutics, Inc. | $20 |
| Exeltis, USA Inc. | $17 |
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: 2012-08-20
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 |
|---|---|---|---|---|
| I20120820000910 | I | Obstetrics/Gynecology | UT | 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 84074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| - | UT | |
| Physician Assistant | TX | |
| Nurse Practitioner | UT | |
| General Surgery | UT | |
| Nurse Practitioner | UT | |
| Diagnostic Radiology | MT | |
| Nurse Practitioner, Family Practice | UT | |
| - | UT | |
| Nurse Practitioner | UT |
Reviews
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