Organization Active NPI

KCS Medical Consulting LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Huntingdon Valley, PA
National Provider Identifier
1376358952
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
KCS MEDICAL CONSULTING LLC
Practice address
380 Red Lion Rd
Huntingdon Valley, PA 19006-6451
Phone
(267) 277-3668
NPI assigned
Feb 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Dr. Oluwatobi Emmanuel Menawonu, PHMNP
Title
Director
Phone
(215) 834-3656

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

380 Red Lion Rd
Huntingdon Valley, PA 19006-6451

Mailing address

7001 Rising Sun Ave
Philadelphia, PA 19111-3941
Phone (215) 834-3656

Other names 1

  • KCS Medical AND PSYCH Consulting LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220803003984 PA Part B Supplier - Clinic/Group Practice 1557743705 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntingdon Valley, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

380 Red Lion Rd
Huntingdon Valley, PA 19006
Phone (215) 870-6296

380 Red Lion Rd
Ste 240
Huntingdon Valley, PA 19006
Phone (215) 494-0325

7001 Rising Sun Ave
Philadelphia, PA 19111

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1376358952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113941",
            "telephone_number": "215-834-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 RED LION RD",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066451",
            "telephone_number": "267-277-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCS MEDICAL CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "MENAWONU",
        "authorized_official_first_name": "OLUWATOBI",
        "authorized_official_middle_name": "EMMANUEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-834-3656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHMNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KCS Medical AND PSYCH Consulting LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntingdon Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.