Lacey Zack, MD Inc
NPI 1205301397ActiveOrganization· Orthopaedic Surgery, Sports Medicine· Los Angeles, CA
Orthopaedic Surgery, Sports Medicine in Los Angeles, California, registered in NPPES in October 2018. The authorized official on file is Lacey Zack, MD, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205301397 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 4, 2018 |
| Last updated in NPPES | Jan 6, 2020 |
| Certified by provider | Jan 6, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery, Sports Medicine Primary | 207XX0005X | — | — |
| Orthopaedic Surgery | 207X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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