Individual provider Active NPI

Lisette Volckmar, M.D.

  • Specialist
  • Abington, PA
National Provider Identifier
1679577910
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD061023L Issued in NJ
Practice address
1200 Old York Rd
Abington, PA 19001-3720
Phone
(215) 481-2000
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD061023L NJ Primary

Addresses

Primary practice location

1200 Old York Rd
Abington, PA 19001-3720

Mailing address

P.O. Box 8500-5365
Philadelphia, PA 19178-0001
Phone (201) 804-2800

Other identifiers 1

IdentifierTypeStateIssuer
1642062MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040129000111 PA Practitioner - AnesthesiologyPractitioner - Pain Management 6709789639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Temple University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia, Pennsylvania , LLCGroup PAC ID 7517960834, 302 clinicians

Practice addresses (Care Compare)

1600 E High St
Pottstown Memorial Medical Center
Pottstown, PA 19464-5008
Phone (610) 327-7008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD061023LNJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia, Pennsylvania , LLC CurrentSince Jan 1, 2017 Accepting new patients
S.E. PA Pain Management CurrentSince Jul 9, 2012 Accepting new patients
SE Pain Management, LTD Specialist CurrentSince Jul 9, 2012 Accepting new patients
Anesthesia Associates of Abington Specialist Past Accepting new patients

Locations

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1679577910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8500-5365",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "201-804-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLCKMAR",
        "first_name": "LISETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MD061023L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1642062",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

Verify at the official NPI Registry.