Individual provider Active NPI

Lisa Beth Freedman, M.D.

  • Adult Medicine Physician
  • Villanova, PA
National Provider Identifier
1073571626
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD063118L Issued in PA
Practice address
2017 Montgomery Ave
Villanova, PA 19085-1818
Phone
(215) 796-1700
Fax
(215) 938-8438
NPI assigned
May 3, 2006
Last updated
Mar 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD063118L PA Primary

Addresses

Primary practice location

2017 Montgomery Ave
Villanova, PA 19085-1818

Mailing address

2017 Montgomery Ave
Villanova, PA 19085-1818
Phone (215) 796-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040220000934 PA Practitioner - Family Practice 0749175396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2017 Montgomery Ave
Villanova, PA 19085-1818
Phone (215) 796-1700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kosmorsky Medical Associates, LLC Past Accepting new patients
A.G. Dikengil, MD, PA PastSince Jan 29, 2024 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1073571626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 MONTGOMERY AVE",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851818",
            "telephone_number": "215-796-1700",
            "fax_number": "215-938-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 MONTGOMERY AVE",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851818",
            "telephone_number": "215-796-1700",
            "fax_number": "215-938-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "LISA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "MD063118L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villanova, PA

Sources for this page

Verify at the official NPI Registry.