Individual provider Active NPI

Alissa Ray Lenz-Laporta, DO

  • Family Medicine Physician
  • Taylor Mill, KY
National Provider Identifier
1093383127
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05690 Issued in KY
Practice address
5100 Peace Way
Taylor Mill, KY 41015-3506
Phone
(859) 491-2855
Fax
(859) 655-4395
NPI assigned
Jun 15, 2021
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05690 KY Primary

Addresses

Primary practice location

5100 Peace Way
Taylor Mill, KY 41015-3506

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 491-2855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240916003700 KY Practitioner - Family Practice 8729529904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

5100 Peace Way
Taylor Mill, KY 41015-3506
Phone (859) 491-2855

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05690KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients
Summit Medical Group, Inc. Family Medicine CurrentSince Aug 26, 2024 Accepting new patients

Locations

1360 Dolwick Dr
Erlanger, KY 41018
Phone (800) 737-7900

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: alenz351771@direct-prd.stelizabeth.com

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 4

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1093383127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-491-2855",
            "fax_number": "859-655-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 PEACE WAY",
            "city": "TAYLOR MILL",
            "state": "KY",
            "postal_code": "410153506",
            "telephone_number": "859-491-2855",
            "fax_number": "859-655-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ-LAPORTA",
        "first_name": "ALISSA",
        "middle_name": "RAY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor Mill, KY

Sources for this page

Verify at the official NPI Registry.