Lisa M Maldonado

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD040338L Issued in PA

Practice address

3 Golf View Dr
Lafayette Hill, PA 19444-1747

Phone

(610) 526-0563

Fax

(610) 940-0117

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Lisa M Maldonado Professional name

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

Specialty

Psychiatry

Education

Ponce School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

West Phila Community Mental Health Consortium, Inc.Group PAC ID 9638072580, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• West Phila Community Mental Health Consortium, Inc.

  • Counselor
  • Philadelphia, PA
  • NPI 1194757989
  Medicare reassignment Care Compare group NPD
• West Philadelphia Community MH Consortium Inc.

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1245350081
  NPD

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346398682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GOLF VIEW DR",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194441747",
            "telephone_number": "610-526-0563",
            "fax_number": "610-940-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GOLF VIEW DR",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194441747",
            "telephone_number": "610-526-0563",
            "fax_number": "610-940-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD040338L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MALDONADO",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael Frederick Lochetto, OD
• Cara Long
• Lumicare, Inc.
• Marcia Cohn Lundy, MSPA
• Main Line Testing Solutions, LLC
• Hibbat Malik, DMD
• Talia Malka, R.AC, L.AC
• Bruce Markovitz, M.D.
• Masonic Villages of the Grand Lodge of Pennsylvania
• Christopher Michael Massella

• Child & Adolescent Psychiatry Physician in Lafayette Hill, PA
• Providers in Lafayette Hill, PA by specialty
• Child & Adolescent Psychiatry 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.