Individual provider Active NPI

Denyse Marie Allen, M.D.

  • Family Medicine Physician
  • Lebanon, PA
National Provider Identifier
1720137177
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-032127-E Issued in PA
Practice address
1701 Cornwall Rd Ste 201
Lebanon, PA 17042-7480
Phone
(717) 675-1780
Fax
(717) 675-1787
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 170213 NY
Public Health & General Preventive Medicine Physician 2083P0901X MD-032127-E PA
Family Medicine Physician 207Q00000X MD-032127-E PA Primary

Addresses

Primary practice location

1701 Cornwall Rd Ste 201
Lebanon, PA 17042-7480

Mailing address

1701 Cornwall Rd Ste 201
Lebanon, PA 17042-7480
Phone (717) 675-1780

Other identifiers 3

IdentifierTypeStateIssuer
03212100OtherPABLUE CROSS-KEYSTONE
488777OtherPABLUE SHIELD
001065331MedicaidPA

Other names 1

  • Dr. Denise Marie Allen Former name

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
I20080619000313 PA Practitioner - Family PracticePractitioner - Other (Physician) 2668543695 Practice locations: Lebanon, PA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170213NYMDFamily Medicine Physician
MD-032127-EPAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1720137177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 CORNWALL RD STE 201",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427480",
            "telephone_number": "717-675-1780",
            "fax_number": "717-675-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 CORNWALL RD STE 201",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427480",
            "telephone_number": "717-675-1780",
            "fax_number": "717-675-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DENYSE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "170213",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "PA",
            "license": "MD-032127-E",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-032127-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-KEYSTONE",
            "identifier": "03212100",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "488777",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001065331",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "ALLEN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.