Individual provider Active NPI

Melissa Kenig, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1770711640
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT012877 Issued in PA
Practice address
3998 Red Lion Rd
Philadelphia, PA 19114-1436
Phone
(215) 612-2691
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT012877 PA Primary

Addresses

Primary practice location

3998 Red Lion Rd
Philadelphia, PA 19114-1436

Mailing address

170 Marc LN
Huntingdon Valley, PA 19006-3103

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
I20130321000041 PA Practitioner - Family Practice 0143465294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

1100 Horizon Cir
Chalfont, PA 18914-3971
Phone (215) 394-0400

216 Mall Blvd
Suite 200
King of Prussia, PA 19406-2923
Phone (856) 872-7055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012877PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Aria Health Physician Services CurrentSince Nov 1, 2017 Accepting new patients
Aria Health Physician Services Family Medicine Current Accepting new patients
Advocare, LLC Family Medicine CurrentSince Oct 4, 2024 Accepting new patients
Advocare , LLC CurrentSince Oct 4, 2024 Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

5000 Bensalem Blvd
Bensalem, PA 19020
Phone (215) 638-4340

1100 Horizon Cir
Ste 101
Chalfont, PA 18914
Phone (215) 394-0400

216 Mall Blvd
Ste 200
King of Prussia, PA 19406
Phone (267) 273-1196

240 Middletown Blvd
Ste 101C
Langhorne, PA 19047
Phone (215) 550-9999

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

Interoperability endpoints

  • Direct secure messaging: melissa.kenig@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 6

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1770711640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MARC LN",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190063103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141436",
            "telephone_number": "215-612-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENIG",
        "first_name": "MELISSA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT012877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.