Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lazare Shadzeka

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1760015010

Lazare Shadzeka is a Nurse Practitioner in Largo, Maryland. Qualified in 2019, 7 years ago. Practices with Innovative Healthcare Training, Inc, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in District of Columbia and Maryland.

Years since qualifying
7
Licensed in
DC, MD
In the registry since
2020
Specialties on file
2

Practice location Address checks out

10530 Campus Way S # 1068
Largo, MD 20774-1309
Phone: (240) 305-5298
Fax: (202) 953-6719
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence RN1033678 (DC)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence R207679 (MD)

Record details

NPI number1760015010
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 14, 2020
Last updated in NPPESSeptember 9, 2024
Certification dateSeptember 9, 2024
Mailing address49b Joyceton Ter, Upper Marlboro, MD 20774-1341

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Innovative Healthcare Training, Inc. — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Largo