Individual provider Active NPI

Lex Denysenko, M.D.

  • Psychiatry Physician
  • Cherry Hill, NJ
National Provider Identifier
1871737759
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD441815 Issued in PA
Practice address
2250 Chapel Ave W
Suite 100
Cherry Hill, NJ 08002
Phone
(856) 482-9000
Fax
(856) 482-1159
NPI assigned
Apr 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X 25MA09822900 NJ
Psychiatry Physician 2084P0800X 25MA09822900 NJ
Psychiatry Physician 2084P0800X MD441815 PA Primary

Addresses

Primary practice location

2250 Chapel Ave W
Suite 100
Cherry Hill, NJ 08002

Mailing address

900 Walnut St FL 2
Philadelphia, PA 19107-5509
Phone (215) 955-2243

Other practice location 1

2250 Chapel Ave W
Suite 100
Cherry Hill, NJ 08002-2051
Phone (856) 482-9000

Other identifiers 1

IdentifierTypeStateIssuer
0500461MedicaidNJ

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
I20110809000078 PA Practitioner - NeurologyPractitioner - Psychiatry 2365611357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Perelman School of Med at the University of Pennsylvania, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

900 Walnut St 2ND Floor
Jeff Hosp for Neuro
Philadelphia, PA 19107-5191
Phone (215) 955-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09822900NJMDPsychosomatic Medicine Physician
MD441815PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jul 1, 2018 Accepting new patients

Locations

900 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-1234

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1871737759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WALNUT ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075509",
            "telephone_number": "215-955-2243",
            "fax_number": "215-955-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 CHAPEL AVE W",
            "address_2": "SUITE 100",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Chapel Ave W",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022051",
            "country_code": "US",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENYSENKO",
        "first_name": "LEX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NJ",
            "license": "25MA09822900",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09822900",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD441815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500461",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.