MEDICARE: LOTUS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1124997812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS LLC

Provider Business Mailing Address
First Line	:	3480 TODOS SANTOS ST APT C304
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-6212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2945 RODEO PARK DR E UNIT 5
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6312
Country	:	US
Telephone Number	:	505-416-8484
Fax Number	:	505-702-8556

Authorized Official
Title or Position	:	MD
Name	:	TRISHA JAYANTILAL PATEL
Credential	:
Telephone Number	:	903-815-0274

Provider Enumeration Date	:	11/01/2025
Last Update Date	:	02/02/2026

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Directions to “LOTUS LLC ” Practice Location

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