NPIMap

Individual provider Active NPI

Kenneth R Lander, M.D.

  • Pulmonary Disease Physician
  • Upland, PA
National Provider Identifier
1154318988
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD055520L Issued in PA
Practice address
30 Medical Center Blvd
Suite 202
Upland, PA 19013-3955
Phone
(610) 447-8840
Fax
(610) 447-8895
NPI assigned
Oct 6, 2005
Last updated
Oct 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD055520L PA Primary

Addresses

Primary practice location

30 Medical Center Blvd
Suite 202
Upland, PA 19013-3955

Mailing address

30 Medical Center Blvd
Suite 202
Upland, PA 19013-3955
Phone (610) 447-8840

Other identifiers 1

IdentifierTypeStateIssuer
0017760570002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041103000149 PA Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6305808312 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Medical Ctr Blvd
Suite 202
Chester, PA 19013-3956
Phone (610) 447-8840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth R Lander M.D. P.C. Pulmonary Disease CurrentSince Sep 15, 2004 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Mar 17, 2018 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Mar 17, 2018 Accepting new patients
Respiratory Associates, LTD Past Accepting new patients

Locations

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

30 Medical Center Blvd
Ste 202
Chester, PA 19013
Phone (610) 447-8840

300 Evergreen Dr
Ste 130
Glen Mills, PA 19342
Phone (610) 521-4833

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 6

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1154318988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD",
            "address_2": "SUITE 202",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133955",
            "telephone_number": "610-447-8840",
            "fax_number": "610-447-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD",
            "address_2": "SUITE 202",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133955",
            "telephone_number": "610-447-8840",
            "fax_number": "610-447-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDER",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD055520L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017760570002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, PA

Sources for this page

Verify at the official NPI Registry.