Individual provider Active NPI

Kenneth M. Certa, M.D.

  • Psychiatry Physician
  • Doylestown, PA
National Provider Identifier
1962416651
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD024309E Issued in PA
Practice address
500 N West St
Doylestown, PA 18901-2366
Phone
(215) 955-6655
Fax
(215) 923-8219
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD024309E PA Primary

Addresses

Primary practice location

500 N West St
Doylestown, PA 18901-2366

Mailing address

500 N West St
Doylestown, PA 18901-2366

Other identifiers 3

IdentifierTypeStateIssuer
0009959520007MedicaidPA
CE416500OtherPABLUE SHIELD OF PA
260038235OtherRR MEDICARE

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
I20050112000250 PA Practitioner - Psychiatry 7719935154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Jefferson Medical College of Thomas Jefferson University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lenape Valley FoundationGroup PAC ID 7719960913, 66 clinicians

Practice addresses (Care Compare)

500 N W St
Doylestown, PA 18901-2366
Phone (215) 345-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD024309EPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lenape Valley Foundation Psychiatry CurrentSince Jul 14, 2025 Accepting new patients
Jefferson University Physicians CurrentSince Mar 19, 1985 Accepting new patients
Lenape Valley Foundation Psychiatry CurrentSince Jul 14, 2025 Accepting new patients
Lenape Valley Foundation Psychiatry Past Accepting new patients

Locations

500 N West St
Doylestown, PA 18901
Phone (267) 893-5118

595 W State St
Doylestown, PA 18901
Phone (215) 345-2200

833 Chestnut St
Ste 210
Philadelphia, PA 19107
Phone (215) 955-5638

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1962416651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WEST ST",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WEST ST",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012366",
            "telephone_number": "215-955-6655",
            "fax_number": "215-923-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERTA",
        "first_name": "KENNETH",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD024309E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009959520007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF PA",
            "identifier": "CE416500",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "260038235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

Verify at the official NPI Registry.