Kenneth R Lisi, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

013087 Issued in CT

Practice address

2979 Main St
Bridgeport, CT 06606-4252

Phone

(203) 333-8800

Fax

(203) 384-5157

NPI assigned

Jul 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1861499824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064252",
            "telephone_number": "203-333-8800",
            "fax_number": "203-384-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064252",
            "telephone_number": "203-333-8800",
            "fax_number": "203-384-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISI",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "013087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard J Link, M.D.
• Victor Linzau, PA-C
• Leonard Lipton, DDS
• Aimee L Liseo, R.D.H.
• Julia Lisi, CRNA
• Kristine M Lisi, MD
• Rose Lisi, RN
• Marie Dorothea Lisieski, LCSW
• Paige Lisk
• Little Big Steps, LLC

• Cardiovascular Disease Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Cardiovascular Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.