Individual provider Active NPI

Lakshmaiah Pola, MD

  • Gastroenterology Physician
  • Middleburg Heights, OH
National Provider Identifier
1952300642
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35040398 Issued in OH
Practice address
7255 Old Oak Blvd
Suite C412
Middleburg Heights, OH 44130-3329
Phone
(440) 816-4546
Fax
(440) 816-4549
NPI assigned
Jul 15, 2005
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35040398 OH Primary

Addresses

Primary practice location

7255 Old Oak Blvd
Suite C412
Middleburg Heights, OH 44130-3329

Mailing address

7255 Old Oak Blvd
Suite C412
Middleburg Heights, OH 44130-3329
Phone (440) 816-4546

Other identifiers 1

IdentifierTypeStateIssuer
0468579MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35040398OHMDGastroenterology Physician

Interoperability endpoints

  • Direct secure messaging: lpola@direct.swgeneral.com

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1952300642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 OLD OAK BLVD",
            "address_2": "SUITE C412",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303329",
            "telephone_number": "440-816-4546",
            "fax_number": "440-816-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 OLD OAK BLVD",
            "address_2": "SUITE C412",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303329",
            "telephone_number": "440-816-4546",
            "fax_number": "440-816-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLA",
        "first_name": "LAKSHMAIAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35040398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468579",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.