Lancaster General Medical Group
Organization Active NPI Family Medicine Physician · Manheim, PA
NPI 1922081371 · NPPES record last updated Nov 17, 2020
Key facts
- NPI
- 1922081371
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LANCASTER GENERAL MEDICAL GROUP
- Practice address
- 700 Lancaster Rd
Manheim, PA 17545-2314 - Phone
- (717) 665-2496
- Fax
- (717) 665-6345
- NPI assigned
- Nov 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Denise Kennedy
- Title
- Vice President Financial Services
- Phone
- (717) 544-5010
Corporate family (same tax ID) 26
Practitioners 11
-
Sarah Eiser, M.D.
-
Melissa Hubley, DO
-
Ashley Anne Kempsell, M.D.
-
Jonathan T Kinley, D.O.
-
Summer Mitchell, CRNP
-
Janna G Semenuk, M.D.
-
Christopher Sobeck, CRNP
-
Dustin Lee Yothers, PA-C
-
Cynthia Lynn Abachnou, APRN
-
Rebecca Kochanowicz, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0676487 | Manheim Family Medicine | Certificate of waiver | Jul 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Martha K Jenson MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
700 Lancaster Rd
Manheim, PA 17545-2314
Mailing address
700 Lancaster Rd
Manheim, PA 17545-2314
Phone (717) 665-2496
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03128600 | Other | PA | CAPITAL BLUE CROSS |
| 1007327490073 | Medicaid | PA | |
| 5897045 | Other | PA | AETNA NON-HMO |
| 85048 | Other | PA | AETNA CAP OFFICE# |
| 1518492 | Other | PA | GATEWAY HEALTH PLAN |
| 725913 | Other | PA | HIGHMARK BLUE SHIELD |
| 558423 | Other | PA | AETNA HMO |
| CD8099 | Other | PA | RAILROAD MEDICARE |
| S1QH | Other | PA | GEISINGER HEALTH PLAN |
Other names
- Penn Medicine LGHP Family Medicine Manheim
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Manheim, PA
- Jin Deok Kim
- Krista Anne Kirchner
- Lori Koch
- Jacqueline Ann Krezmien
- Lancaster Gals PC
- Lancaster Medical Group, LLC
- Alec Levesque
- Little Voices, LLC
- Miranda Maney
- Manheim Central School District
All providers in Manheim, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.