Individual provider Active NPI

Ebony Lashay Love, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
National Provider Identifier
1083916720
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001150 Issued in GA
Practice address
148 N 8TH St
Philadelphia, PA 19107-2418
Phone
(215) 777-5808
Fax
(215) 777-5825
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001150 GA
Foot & Ankle Surgery Podiatrist 213ES0103X POD001150 GA Primary

Addresses

Primary practice location

148 N 8TH St
Philadelphia, PA 19107-2418

Mailing address

PO Box 22433
New York, NY 10087-2433
Phone (215) 777-5808

Other identifiers 3

IdentifierTypeStateIssuer
003118774AMedicaidGA
511G700902OtherGAGROUP MEDICARE PTAN
202I481075OtherGAINDIVIDUAL MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140430000964 PA Practitioner - Podiatry 3476731258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3223 N Broad St
Suite 150
Philadelphia, PA 19140-5007
Phone (215) 777-5808

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue25
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
620SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Temple University of the Commonwealth System of Higher Education PastSince Sep 24, 2023 Accepting new patients
Temple University of the Commonwealth System of Higher Education Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1083916720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22433",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100872433",
            "telephone_number": "215-777-5808",
            "fax_number": "215-777-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 N 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072418",
            "telephone_number": "215-777-5808",
            "fax_number": "215-777-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "EBONY",
        "middle_name": "LASHAY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001150",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003118774A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "511G700902",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PTAN",
            "identifier": "202I481075",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.