Individual provider Active NPI

Lonzo Smith

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1114376720
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340491 Issued in NY
Practice address
4374 Edson Ave
Bronx, NY 10466-1814
Phone
(718) 654-9695
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340491 NY Primary

Addresses

Primary practice location

4374 Edson Ave
Bronx, NY 10466-1814

Mailing address

4374 Edson Ave
Bronx, NY 10466-1814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214000089 NY Practitioner - Nurse Practitioner 0941568224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urban Health Plan IncGroup PAC ID 3173517281, 158 clinicians

Practice addresses (Care Compare)

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F340491NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Sep 24, 2017 Accepting new patients
Urban Health Plan, Inc. CurrentSince Sep 24, 2017 Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients

Locations

1967 Turnbull Ave
Bronx, NY 10473
Phone (718) 684-1320

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

866 E Tremont Ave
Bronx, NY 10460
Phone (347) 284-0595

1764 Westchester Ave
#66
Bronx, NY 10472

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1114376720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 EDSON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104661814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 EDSON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104661814",
            "telephone_number": "718-654-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LONZO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.