NPIMap

Individual provider Active NPI

Lara Blumberg, MD

  • Family Medicine Physician
  • Canal Winchester, OH
National Provider Identifier
1174532477
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-08-2507 Issued in OH
Practice address
6201 Gender Rd
Canal Winchester, OH 43110-2007
Phone
(614) 834-8042
Fax
(614) 837-8035
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-08-2507 OH Primary

Addresses

Primary practice location

6201 Gender Rd
Canal Winchester, OH 43110-2007

Mailing address

6201 Gender Rd
Canal Winchester, OH 43110-2007
Phone (614) 834-8042

Other identifiers 1

IdentifierTypeStateIssuer
2425781MedicaidOH

Other names 1

  • Lara Salminis Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000113 OH Practitioner - Family Practice 2567477516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

6201 Gender Rd
Canal Winchester, OH 43110-2007
Phone (614) 834-8042

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Diley Ridge Medical Center Hospital, Canal Winchester, OH, CCN 360358
  • Adena Regional Medical Center Hospital, Chillicothe, OH, CCN 360159
  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: lblumberg18817@copcp.medicity.net

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1174532477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102007",
            "telephone_number": "614-834-8042",
            "fax_number": "614-837-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102007",
            "telephone_number": "614-834-8042",
            "fax_number": "614-837-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMBERG",
        "first_name": "LARA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-08-2507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2425781",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "SALMINIS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canal Winchester, OH

Sources for this page

Verify at the official NPI Registry.