Individual provider Active NPI

Lydia Koroshetz, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1245855485
Registry record updated Jun 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT220245 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-2000
NPI assigned
Jun 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A186182 CA
Emergency Medicine Physician 207P00000X MT220245 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

2037 Mount Vernon St Apt 2R
Philadelphia, PA 19130-3224
Phone (240) 994-7929

Other practice location 1

300 W Huntington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Other practice location 2

1200 N State St
Los Angeles, CA 90089-1001
Phone (323) 226-2622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230530001275 CA Practitioner - Emergency Medicine 8325460876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Georgetown University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186182CAMDEmergency Medicine Physician
MT220245PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2023 Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1200 N State St
Los Angeles, CA 90089
Phone (323) 226-2170

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.

Hospital & facility affiliations 4

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": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686355200000",
    "number": "1245855485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 MOUNT VERNON ST APT 2R",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303224",
            "telephone_number": "240-994-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Huntington Dr",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910073402",
            "country_code": "US",
            "telephone_number": "626-898-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 N State St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900891001",
            "country_code": "US",
            "telephone_number": "323-226-2622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOROSHETZ",
        "first_name": "LYDIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-13",
        "last_updated": "2023-06-10",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A186182",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT220245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.