Larry L Lodge, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD002054 Issued in NJ

Practice address

200 Route 73 Ste 3
Voorhees, NJ 08043-9542

Phone

(856) 753-1300

Fax

(856) 768-2965

NPI assigned

Aug 25, 2005

Sex

Male

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Garden State Foot Care

  • Foot Surgery Podiatrist
  • Voorhees, NJ
  • NPI 1275700205
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1497748354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 B ROUTE 73, SUITE 3",
            "address_2": "GARDEN STATE FOOT CARE",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439542",
            "telephone_number": "856-753-1300",
            "fax_number": "856-768-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROUTE 73 STE 3",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439542",
            "telephone_number": "856-753-1300",
            "fax_number": "856-768-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "LARRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD002054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Q Liu, PTA
• Daniel Liu, M.D.
• Live Love Homecare LLC
• Dan Andrew Lizardo
• Brittany Loatman
• Nittal Kalusing Lodha, RPH
• Devang V Lodhavia, M.D.
• Kristen Marie Logan, CPRS
• Taylor Kathleen Logan, PT, DPT
• Mathushana Logeswaran

• Podiatrist in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.