Lara Enid Smith, MD in Boston, MA - Medicare Family Practice

Lara Enid Smith, MD is a medicare enrolled "Family Medicine" physician in Boston, Massachusetts. She graduated from medical school in 2012 and has 14 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Form Health Associates Ma, P.c. and her current practice location is 109 State St, 5th Fl, Boston, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (617) 505-1520.

Lara Enid Smith is licensed to practice in Illinois (license number 036167275) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1215386800.

Contact Information

	Lara Enid Smith, MD
	109 State St, 5th Fl, Boston, MA 02109-2906
	(617) 505-1520
	(617) 928-8401

Map and Direction

Physician's Profile

Full Name	Lara Enid Smith
Gender	Female
Speciality	Family Practice
Experience	14 Years
Location	109 State St, Boston, Massachusetts
Accepts Medicare Assignments	May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lara Enid Smith graduated from medical school in 2012

NPI Data:

NPI Number: 1215386800
Provider Enumeration Date: 06/06/2016
Last Update Date: 03/20/2026

Medicare PECOS Information:

PECOS PAC ID: 4981982824
Enrollment ID: I20240802003237

Medical Identifiers

Medical identifiers for Lara Enid Smith such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215386800	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	78755 (Georgia)	Secondary
207Q00000X	Family Medicine	TPME4914 (Florida)	Secondary
207Q00000X	Family Medicine	036167275 (Illinois)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Form Health Associates Ma, P.c.	3375953961	35

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lara Enid Smith allows following entities to bill medicare on her behalf.

Entity Name	Form Health Associates Ma Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386260594 PECOS PAC ID: 3375953961 Enrollment ID: O20201228002173

Entity Name	Deaconess Illinois Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962128256 PECOS PAC ID: 5092187021 Enrollment ID: O20230220002667

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lara Enid Smith is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lara Enid Smith, MD 109 State St, 5th Fl, Boston, MA 02109-2906 Ph: (617) 505-1520	Lara Enid Smith, MD 109 State St, 5th Fl, Boston, MA 02109-2906 Ph: (617) 505-1520

Reviews and Comments

Family Medicine Doctors in Boston, MA

Lidya H Wlasiuk, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 850 Harrison Ave, Yacc 5, Boston, MA 02118 Phone: 617-414-2080 Fax: 617-414-2090
Nestor Alejandro Sainz Rueda, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 55 Fruit St, Boston, MA 02114 Phone: 800-711-4644
Madhuri Preeti Rao, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 55 Fruit St, Boston, MA 02114 Phone: 617-889-8580
Brian R Penti, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 850 Harrison Ave, Yacc 4, Boston, MA 02118 Phone: 617-414-2080 Fax: 617-414-2090
Shahnaz Rahman, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 820 Harrison Ave, Boston, MA 02118 Phone: 404-259-4008
Dr. Victor Wan, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 800 Washington St, Boston, MA 02111 Phone: 617-636-5000
Dr. Amy Min He, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 637 Washington St, Boston, MA 02124 Phone: 617-825-9660

Lara Enid Smith, MD - Medicare Family Practice in Boston, MA