Individual provider Active NPI

Samantha Alyssa Loza, MD

  • Pediatrics Physician
  • Columbus, IN
National Provider Identifier
1982263307
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01087608A Issued in IN
Practice address
2150 25TH St Ste B
Columbus, IN 47201-3243
Phone
(812) 376-9219
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125.074318 IL
Pediatrics Physician 208000000X 01087608A IN Primary

Addresses

Primary practice location

2150 25TH St Ste B
Columbus, IN 47201-3243

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (319) 655-2274

Other identifiers 1

IdentifierTypeStateIssuer
300065888MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sloza35889@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220819002349 IN Practitioner - Pediatric Medicine 4385076306 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.074318ILMDPediatrics Physician
01087608AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC CurrentSince Aug 17, 2022 Accepting new patients
Columbus Regional Health Physicians, LLC Pediatrics CurrentSince Aug 17, 2022 Accepting new patients
Major Hospital Past Accepting new patients
Columbus Regional Health Physicians, LLC Past Accepting new patients

Locations

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

1120 N Marr Rd
Columbus, IN 47201
Phone (317) 948-8896

2150 25th St
Ste B
Columbus, IN 47201
Phone (812) 376-9219

Interoperability endpoints

  • Direct secure messaging: sloza35889@edirect.crh.org

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1982263307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 25TH ST STE B",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013243",
            "telephone_number": "812-376-9219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "319-655-2274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOZA",
        "first_name": "SAMANTHA",
        "middle_name": "ALYSSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.074318",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01087608A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300065888",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sloza35889@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct address",
            "address_1": "1120 N Marr Rd",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.