Active NPI
Lisa J Heller, MD
- Pediatrics Physician
- Bryn Mawr, PA
National Provider Identifier
1245267145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD040369E
- Practice address
- 950 Haverfor Rd
Ste 107
Bryn Mawr, PA 19010 - Phone
- (610) 527-4715
- Fax
- (610) 527-3649
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD040369E | PA | Primary |
Addresses
Primary practice location
950 Haverfor Rd
Ste 107
Bryn Mawr, PA 19010
Mailing address
950 Haverfor Rd
Ste 107
Bryn Mawr, PA 19010
Phone (610) 527-4715
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD040369E | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gordon Klinow Pediatric Associates LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Bryn Mawr, PA
- NPI 1013946664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245267145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 HAVERFOR RD",
"address_2": "STE 107",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "19010",
"telephone_number": "610-527-4715",
"fax_number": "610-527-3649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 HAVERFOR RD",
"address_2": "STE 107",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "19010",
"telephone_number": "610-527-4715",
"fax_number": "610-527-3649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLER",
"first_name": "LISA",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD040369E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.