Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lara Enid Smith, MD

Individual provider Family Medicine Physician · NPI 1215386800

Lara Enid Smith, MD is a Family Practice in Boston, Massachusetts. Qualified in 2012, 14 years ago. Practices with Form Health Associates MA, PC, a 39-clinician group and offers telehealth. Licensed in Florida, Georgia and Illinois.

Years since qualifying
14
Licensed in
FL, GA, IL
In the registry since
2016
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

109 State St 5th Fl
Boston, MA 02109-2906
Phone: (617) 505-1520
Fax: (617) 928-8401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036167275 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 78755 (GA)
Family Medicine Physician Taxonomy 207Q00000X · Licence TPME4914 (FL)

Record details

NPI number1215386800
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2016
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Form Health Associates Ma, P.C. — 39 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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