Mary B Lodge, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC005680 Issued in PA

Practice address

75 Washington Ave
Plymouth, PA 18651-1744

Phone

(570) 287-1955

NPI assigned

Aug 4, 2006

Last updated

Oct 6, 2026By 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 NY

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Capital Foot Specialists

  • Podiatrist
  • Rotterdam, NY
  • NPI 1558455477
  Medicare reassignment NPD Authorized official
• N.E.P.a Foot & Ankle Specialists P.C.

  • Foot & Ankle Surgery Podiatrist
  • Plymouth, PA
  • NPI 1730505272
  NPD (past)
• Kurt Wendell Relation DPM PLLC

  • Foot & Ankle Surgery Podiatrist
  • Schenectady, NY
  • NPI 1992647192
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1568470508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON AVE",
            "city": "PLYMOUTH",
            "state": "PA",
            "postal_code": "186511744",
            "telephone_number": "518-287-1955",
            "fax_number": "570-287-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON AVE",
            "city": "PLYMOUTH",
            "state": "PA",
            "postal_code": "186511744",
            "telephone_number": "570-287-1955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3579 Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "PA",
            "postal_code": "186129286",
            "country_code": "US",
            "telephone_number": "570-287-1955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LODGE",
        "first_name": "MARY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC005680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie D Habersham-Johnson, LPN
• Andrew Joseph Krashnak III, DC DACRB CCN DACBN
• Frederick Francis Kuscavage Jr., ATC
• Shelly Ann Levulis, D.P.M.
• Lifesavers CRNP LLC
• Debra Ann McDonald
• Tiffany Mae Michalek
• N.E.P.a Foot & Ankle Specialists P.C.
• Amanda Marie Naperski, MS, LAT, ATC, CES
• Abu Panackal, OTR/L

• Podiatrist in Plymouth, PA
• Providers in Plymouth, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.