Individual provider Active NPI

Lalith K Misra, DO PHD

  • Psychiatry Physician
  • Marion, OH
National Provider Identifier
1730130626
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34.007451 Issued in OH
Practice address
990 S Prospect St Ste 3
Marion, OH 43302-6283
Phone
(740) 383-7910
Fax
(740) 375-8129
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34.007451 OH Primary

Addresses

Primary practice location

990 S Prospect St Ste 3
Marion, OH 43302-6283

Mailing address

# L-3652
Columbus, OH 43260-6453
Phone (740) 383-7927

Other identifiers 11

IdentifierTypeStateIssuer
2056793OtherCIGNA
2205885MedicaidOH
353077OtherSUBMITTER NO
260782000OtherMAGELLAN MIS
311098079OtherTAX ID
000000206898OtherOHANTHEM
260047857OtherTRAVELERS MEDICARE
260782000OtherAETNA
311098079OtherPPO NEXT
320201OtherMT CARMEL BEHAVIORAL HEAL
1555037OtherUHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091201000429 OH Practitioner - Psychiatry 2466534805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Psychiatric Associates IncGroup PAC ID 4183514599, 5 clinicians

Practice addresses (Care Compare)

3162 El Camino Dr
Springfield, OH 45503-1318
Phone (937) 342-9030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
34.007451OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Psychiatric Associates Inc Psychiatry CurrentSince Nov 1, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Marion General Hospital, Inc. Past Accepting new patients

Locations

3162 El Camino Dr
Springfield, OH 45503
Phone (937) 342-9030

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1730130626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "# L-3652",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432606453",
            "telephone_number": "740-383-7927",
            "fax_number": "740-383-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 S PROSPECT ST STE 3",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026283",
            "telephone_number": "740-383-7910",
            "fax_number": "740-375-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISRA",
        "first_name": "LALITH",
        "middle_name": "K",
        "credential": "DO PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.007451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2056793",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2205885",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER NO",
            "identifier": "353077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MIS",
            "identifier": "260782000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "311098079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000206898",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "260047857",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "260782000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO NEXT",
            "identifier": "311098079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT CARMEL BEHAVIORAL HEAL",
            "identifier": "320201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1555037",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.