Individual provider Active NPI

Smita Lodha, MD

  • Family Medicine Physician
  • Corona, NY
National Provider Identifier
1356434310
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
206691 Issued in NY
Practice address
9606 Northern Blvd
Corona, NY 11368-1046
Phone
(718) 335-4747
Fax
(718) 476-2626
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 206691 NY Primary

Addresses

Primary practice location

9606 Northern Blvd
Corona, NY 11368-1046

Mailing address

9606 Northern Blvd
Corona, NY 11368-1046
Phone (718) 335-4747

Other identifiers 2

IdentifierTypeStateIssuer
02020762MedicaidNY
01005BOtherMEDICARE ID

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000073 NY Practitioner - Family Practice 8729985890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens Medical Services PLLCGroup PAC ID 8820993488, 2 clinicians

Practice addresses (Care Compare)

9606 Northern Blvd
Corona, NY 11368-1046
Phone (718) 335-4747

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Care, PC Past Accepting new patients
North Shore-Lij Medical PC Family Medicine Past Accepting new patients
Gastrohealth Medical P.C. PastSince May 16, 2021 Accepting new patients

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEDHAD

Organizations & group practices 4

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1356434310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9606 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681046",
            "telephone_number": "718-335-4747",
            "fax_number": "718-476-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9606 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681046",
            "telephone_number": "718-335-4747",
            "fax_number": "718-476-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODHA",
        "first_name": "SMITA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "206691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02020762",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "01005B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

Verify at the official NPI Registry.