Kenneth L Izzo, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

MD017101 Issued in PA

Practice address

1811 Bethlehem Pike
Suite 221
Flourtown, PA 19031

Phone

(215) 233-1223

Fax

(215) 233-1141

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Flourtown Pain Evaluation and Treatment Center

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Flourtown, PA
  • NPI 1518039833
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285725010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 BETHLEHEM PIKE",
            "address_2": "SUITE 221",
            "city": "FLOURTOWN",
            "state": "PA",
            "postal_code": "19031",
            "telephone_number": "215-233-1223",
            "fax_number": "215-233-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 BETHLEHEM PIKE",
            "address_2": "SUITE 221",
            "city": "FLOURTOWN",
            "state": "PA",
            "postal_code": "19031",
            "telephone_number": "215-233-1223",
            "fax_number": "215-233-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "KENNETH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "PA",
            "license": "MD017101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PERSONAL CHOICE",
            "identifier": "IZ112248",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01927385",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KEYSTONE EAST",
            "identifier": "0060080000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3503051",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• House Call Medical Specialists LLC
• Heather Hultzapple, PHARMD
• Lisa M Hurwitz
• Andrea Ingerson, ATC, LAT
• Institute for Dermatopathology, Inc.
• J Snyder Therapeutic Services
• Jefferson Acute Care Physicians, PC
• Evangelia A Johns, LSW
• Addie Johnson, LPC
• Ciera Lynn Johnson, MD

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Flourtown, PA
• Providers in Flourtown, PA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Pennsylvania

• 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.

Verify at the official NPI Registry.