NPIMap

Organization Active NPI

Lancaster General Medical Group

Doing business as Penn Medicine LGHP Roseville Pediatrics

  • Pediatrics Physician
  • Lititz, PA
National Provider Identifier
1922073865
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Doing business as
Penn Medicine LGHP Roseville Pediatrics
Practice address
51 Peters Rd Ste 202
Lititz, PA 17543-7685
Phone
(717) 569-6481
Fax
(717) 569-5213
NPI assigned
Feb 22, 2006
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Denise Kennedy
Title
Vice President Financial Services
Phone
(717) 544-5010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

51 Peters Rd Ste 202
Lititz, PA 17543-7685

Mailing address

51 Peters Rd Ste 202
Lititz, PA 17543-7685
Phone (717) 569-6481

Other identifiers 9

IdentifierTypeStateIssuer
1007327490226MedicaidPA
4482843OtherPAAETNA NON-HMO
51203OtherPAAETNA HMO
02404600OtherPACAPITAL BLUE CROSS
1508046OtherPAGATEWAY HEALTH PLAN
874348OtherPAHIGHMARK BLUE SHIELD
1001184OtherPAAMERIHEALTH MERCY
5803OtherPAAETNA CAP OFFICE#
S1BXOtherPAGEISINGER HEALTH PLAN

Other names 1

  • Penn Medicine LGHP Roseville Pediatrics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000916 PA Part B Supplier - Clinic/Group Practice 0941103683 Receives reassigned benefits from 886 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

1570 Fruitville Pike
Ste 1
Lancaster, PA 17601

562 W 2nd Ave
Lititz, PA 17543
Phone (717) 626-2167

203 Commerce Dr
Ste G
Quarryville, PA 17566
Phone (717) 284-3137

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1922073865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PETERS RD STE 202",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437685",
            "telephone_number": "717-569-6481",
            "fax_number": "717-569-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 PETERS RD STE 202",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437685",
            "telephone_number": "717-569-6481",
            "fax_number": "717-569-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "717-544-5010"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007327490226",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "4482843",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "51203",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02404600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1508046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "874348",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "1001184",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAP OFFICE#",
            "identifier": "5803",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "S1BX",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Penn Medicine LGHP Roseville Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.