Lisa Rae Kanfoush, O.D.
Individual provider Active NPI Optometrist · Aliquippa, PA
NPI 1992761092 · NPPES record last updated Dec 12, 2007
Key facts
- NPI
- 1992761092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OEG001382 (PA)
- Practice address
- 131 Pleasant Dr
Suite #3
Aliquippa, PA 15001-1300 - Phone
- (724) 378-4457
- Fax
- (724) 378-4541
- NPI assigned
- Apr 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1993
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
131 Pleasant Dr
Suite 4U
Aliquippa, PA 15001-1300
Phone (724) 378-4457
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040115000089 | PA | Practitioner - Optometry | 7214838135 | Practice locations: Aliquippa, PA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG001382 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lisa R Kanfoush OD | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001382 | PA | Yes |
Addresses
Primary practice location
131 Pleasant Dr
Suite #3
Aliquippa, PA 15001-1300
Mailing address
131 Pleasant Dr
Suite #3
Aliquippa, PA 15001-1300
Phone (724) 378-4457
NPI Registry JSON
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197417600000",
"number": "1992761092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 PLEASANT DR",
"address_2": "SUITE #3",
"city": "ALIQUIPPA",
"state": "PA",
"postal_code": "150011300",
"telephone_number": "724-378-4457",
"fax_number": "724-378-4541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 PLEASANT DR",
"address_2": "SUITE #3",
"city": "ALIQUIPPA",
"state": "PA",
"postal_code": "150011300",
"telephone_number": "724-378-4457",
"fax_number": "724-378-4541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANFOUSH",
"first_name": "LISA",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-26",
"last_updated": "2007-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aliquippa, PA
- Joshi Womencare, PC
- Renu Ashwin Joshi
- Gregory Lynn Jovanelly
- Just for You, LLC
- Douglas Kaleugher
- Adria Francesca Keenan
- Jamie Keenan
- Nathan Scott Kelley
- Robert Kelly
- Thomas Maximillian Kempen
All providers in Aliquippa, PA · Optometrist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2007. 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.
- Order and Referring (CMS).
- 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.