Lavanya A Kodavali, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA08022400 Issued in NJ

Practice address

101 Carnie Blvd
Voorhees, NJ 08043-1548

Phone

(856) 762-1940

Fax

(856) 762-1777

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of New Jersey Omb Centralized PayrollGroup PAC ID 6406742592, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of New Jersey Omb Centralized Payroll

  • Psychiatric Hospital
  • Hammonton, NJ
  • NPI 1629155502
  Medicare reassignment Care Compare group NPD
• State of New Jersey Omb Centralized Payroll

  • Psychiatric Hospital
  • Morris Plains, NJ
  • NPI 1336221878
  NPD

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1477598068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SPRING GARDEN RD",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080379699",
            "telephone_number": "609-561-1700",
            "fax_number": "609-561-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CARNIE BLVD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431548",
            "telephone_number": "856-762-1940",
            "fax_number": "856-762-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODAVALI",
        "first_name": "LAVANYA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08022400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200921",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Knoerzer, NP-C
• Michelle Ko, PA-C
• Jessica Kobilas, PA
• Therese K Koch, MSW, CNN, APRN-C
• Amy Kocher
• David Michael Koerner, D.O.
• Ramya Reddy Kommidi, DO
• Leah Kompare
• Rita T. Konzelman, CRNP
• Genevieve Frances Kopec, PA-C

• Internal Medicine Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.