Individual provider Active NPI

Larisa Cheipesh, M.D.

  • Family Medicine Physician
  • Springfield, PA
National Provider Identifier
1114112828
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 434891 Issued in PA
Practice address
965 Baltimore Pike
Suite 2B
Springfield, PA 19064-3976
Phone
(484) 573-5116
Fax
(484) 573-5122
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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 MD 434891 PA Primary

Addresses

Primary practice location

965 Baltimore Pike
Suite 2B
Springfield, PA 19064-3976

Mailing address

965 Baltimore Pike
Suite 2B
Springfield, PA 19064-3976
Phone (484) 573-5116

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
I20081024000441 PA Practitioner - Family Practice 4880752500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 434891PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Nov 1, 2016 Accepting new patients
Pottstown Clinic Company LLC Family Medicine CurrentSince Sep 1, 2008 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

965 Baltimore Pike
Ste B2
Springfield, PA 19064
Phone (484) 479-2600

Organizations & group practices 2

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

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1114112828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 BALTIMORE PIKE",
            "address_2": "SUITE 2B",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643976",
            "telephone_number": "484-573-5116",
            "fax_number": "484-573-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 BALTIMORE PIKE",
            "address_2": "SUITE 2B",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643976",
            "telephone_number": "484-573-5116",
            "fax_number": "484-573-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEIPESH",
        "first_name": "LARISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD 434891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.