Longevity Healthcare LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

LONGEVITY HEALTHCARE LLC

Practice address

111 Alice LN
Mount Pocono, PA 18344-7100

Phone

(570) 972-7879

Fax

(570) 867-9725

NPI assigned

Jan 8, 2026

Last updated

Jan 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Hanna, NPNPI 1649143090

Title

Owner/Provider

Phone

(570) 436-8591

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Hanna, AGPCNP

  • Gerontology Nurse Practitioner
  • Mount Pocono, PA
  • NPI 1649143090
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1316804495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ALICE LN",
            "city": "MOUNT POCONO",
            "state": "PA",
            "postal_code": "183447100",
            "telephone_number": "570-972-7879",
            "fax_number": "570-867-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ALICE LN",
            "city": "MOUNT POCONO",
            "state": "PA",
            "postal_code": "183447100",
            "telephone_number": "570-972-7879",
            "fax_number": "570-867-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "570-436-8591",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidspeace Children's Hospital, Inc.
• Bu Jung Kim, MD
• Jillian Knecht, LPC
• Matthew R. Kozma, D.O.
• Brian Scott Lee, ABO 140728 CEC ID
• Kimberly Ann Martini, RPH
• Terriann McAllister
• Christopher C. Meister, D.C.
• Audralaine N Mentrikoski
• Merakey Pennsylvania

• Geriatric Medicine (Family Medicine) Physician in Mount Pocono, PA
• Providers in Mount Pocono, PA by specialty
• Geriatric Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.