Individual provider Active NPI

Yasodah Toddywalla, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lexington, KY
National Provider Identifier
1124207352
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
38652 Issued in KY
Practice address
1221 S Broadway
Lexington, KY 40504-2701
Phone
(859) 258-4138
Fax
(859) 258-4796
NPI assigned
Oct 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 57012932 OH
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 38652 KY Primary

Addresses

Primary practice location

1221 S Broadway
Lexington, KY 40504-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4138

Other practice location 1

234 Goodman St
Mail Location 0796
Cincinnati, OH 45219-2364
Phone (513) 584-1000

Other practice location 2

550 S Jackson St
Louisville, KY 40202-1622
Phone (502) 852-1819

Other identifiers 1

IdentifierTypeStateIssuer
7100046740MedicaidKY

Other names 1

  • Yasodah Jayamohan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080801000408 KY Practitioner - Pathology 7517031966 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57012932OHMDBlood Banking & Transfusion Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2020 Accepting new patients
St Claire Medical Center, Inc CurrentSince Feb 8, 2017 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Kentucky Medical Services Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Sep 14, 2016 Accepting new patients
St Claire Medical Center, Inc., Anatomic Pathology & Clinical Pathology CurrentSince Feb 8, 2017 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

37 Ball Park Rd
Harlan, KY 40831
Phone (606) 263-3900

81 Ball Park Rd
Harlan, KY 40831
Phone (606) 573-8100

100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

550 S Jackson St
Louisville, KY 40202
Phone (502) 561-8686

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

Organizations & group practices 5

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": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1124207352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4138",
            "fax_number": "859-258-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4138",
            "fax_number": "859-258-4796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Goodman St",
            "address_2": "Mail Location 0796",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192364",
            "country_code": "US",
            "telephone_number": "513-584-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021622",
            "country_code": "US",
            "telephone_number": "502-852-1819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODDYWALLA",
        "first_name": "YASODAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "OH",
            "license": "57012932",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "38652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100046740",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YASODAH",
            "last_name": "JAYAMOHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.