Lisa A Kenis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS006949L Issued in PA

Practice address

2 N Belfield Ave
Havertown, PA 19083-4836

Phone

(610) 733-2819

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Bryn Mawr Medical Specialists Association

  • Multi-Specialty Clinic/Center
  • Bryn Mawr, PA
  • NPI 1841226099
  Medicare reassignment
• Bryn Mawr Medical Specialists Association

  • Internal Medicine Physician
  • Bryn Mawr, PA
  • NPI 1790192441

  Family Medicine

  NPD

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1497807879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N BELFIELD AVE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834836",
            "telephone_number": "610-733-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N BELFIELD AVE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834836",
            "telephone_number": "610-733-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENIS",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-03-22",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006949L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kenisl@mlhs.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 N Belfield Ave",
            "city": "Havertown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190834836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiley Keenan, RDN
• Melissa Kelly, BCBA
• Rachel Kelly, BS
• William Kelly, PH.D.
• George James Kenis, DO
• Keshavam Dental
• Zinneh Kesselly-Kpanabom, LCSW
• Key Compassion Care and Services LLC
• Jacques Khoury, M.D.
• Kelly Kiefer

• Family Medicine Physician in Havertown, PA
• Providers in Havertown, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.