Kelly Anne Lisciandro, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

228369 Issued in NY

Practice address

481 Penbrooke Drive
Suite 2
Penfield, NY 14526

Phone

(585) 364-0025

Fax

(585) 364-0024

NPI assigned

Jul 29, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 19, 2024 through Aug 19, 2026

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1689674814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 PENBROOKE DRIVE STE",
            "address_2": "SUITE 2",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "14526",
            "telephone_number": "585-364-0025",
            "fax_number": "585-364-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 PENBROOKE DRIVE",
            "address_2": "SUITE 2",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "14526",
            "telephone_number": "585-364-0025",
            "fax_number": "585-364-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISCIANDRO",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "228369-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "228369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "115965BJ",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7441491",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02423485",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010228369",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Beth Lovett-Standish, OD, MBA

• Internal Medicine Physician in Penfield, NY
• Providers in Penfield, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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; Opt Out Affidavits.
• 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.