Lori Iaconis, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

A119805 Issued in CA

Practice address

10675 John Jay Hopkins Drive
La Jolla, CA 92121

Phone

(858) 812-1787

NPI assigned

Dec 13, 2005

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Saint Lukes Roosevelt Hospital - Pathology Dept

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
  • NPI 1801802137

  Anatomic Pathology & Clinical Pathology

  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1770568644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HEMPSTEAD TPKE",
            "address_2": "SUITE 500",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541724",
            "telephone_number": "516-542-1090",
            "fax_number": "516-794-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10675 JOHN JAY HOPKINS DRIVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-812-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5241 Brickfield Ln",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92130",
            "country_code": "US",
            "telephone_number": "646-270-8504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACONIS",
        "first_name": "LORI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2023-03-20",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A119805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Quan-Yu Hwang, M.D.
• Stephanie Sylvia Hwang, M.D.
• Nelson Hwynn, DO
• Paul Vincent Bernard Hyde, M.D.
• Simone Carlson Hyman, MD
• Abigail Joyce Brion Ibarra, NP
• Karla Ibarra
• Fady Ibrahim, M.D.
• Islam Mohamed Ibrahim, MD
• Mai Iesaka, BA

• Anatomic Pathology & Clinical Pathology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.