Lydia T Komarnicky, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

MD029146E Issued in PA

Practice address

216 N Broad St
Philadelphia, PA 19102

Phone

(215) 255-7822

Fax

(215) 255-7825

NPI assigned

Apr 25, 2006

Last updated

Aug 8, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in PA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel CNHP Nurse Practitioner Faculty Practice

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1790203669
  NPD
• Jefferson University Physicians

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1588819338
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1487610820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 N 15th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021101",
            "country_code": "US",
            "telephone_number": "215-762-4984",
            "fax_number": "215-762-3053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19102",
            "country_code": "US",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-6702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191483542",
            "country_code": "US",
            "telephone_number": "215-952-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMARNICKY",
        "first_name": "LYDIA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD029146E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Kolton
• Emily Kolton, CRNP
• Rachel Kolton
• Elysa Kolvek
• Sirisha Komakula
• Jack Komejan, L.C.S.W.
• Orna Komisar, MD
• Jessica Komisor
• Shruti Reddy Kommareddy, DPM
• Kommunison Behavioral Support LLC

• Radiation Oncology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Radiation Oncology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.