Individual provider Active NPI

Lisa Knicos, AU.D.

  • Audiologist
  • Allentown, PA
National Provider Identifier
1992863799
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006720 Issued in PA
Practice address
1210 S Cedar Crest Blvd Ste 1100
Allentown, PA 18103-6241
Phone
(610) 402-7999
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 000338 CT
Audiologist-Hearing Aid Fitter 237600000X 000338 CT
Audiologist 231H00000X AT006720 PA Primary

Addresses

Primary practice location

1210 S Cedar Crest Blvd Ste 1100
Allentown, PA 18103-6241

Mailing address

2100 Mack Blvd FL 2
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

901 Farmington Ave
Ste 3
West Hartford, CT 06119-1418
Phone (860) 586-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070206000352 CT Practitioner - Qualified Audiologist 2466454368 Reassigns benefits to 1 organization
I20230207002261 PA Practitioner - Qualified Audiologist 2466454368 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000338CTMDPsychologist
AT006720PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC CurrentSince May 31, 2016 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 26, 2022 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 26, 2022 Accepting new patients
Bridgeport Hospital Past Accepting new patients
Richard a Levin, MD,DMD,Lawrence J. Fliegelman, M.D.,LLC PastSince Jul 16, 2001 Accepting new patients
Ahlbin Centers for Rehabilitation Medicine Audiologist Past Accepting new patients

Locations

21 South Rd
Farmington, CT 06032
Phone (860) 679-4600

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

1210 S Cedar Crest Blvd
Ste 1100
Allentown, PA 18103
Phone (610) 402-7999

1210 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 402-7999

2100 Mack Blvd
Fl 2
Allentown, PA 18103

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1992863799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 2",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500",
            "fax_number": "860-586-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S CEDAR CREST BLVD STE 1100",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036241",
            "telephone_number": "610-402-7999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 FARMINGTON AVE",
            "address_2": "STE 3",
            "address_purpose": "LOCATION",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191418",
            "country_code": "US",
            "telephone_number": "860-586-2111",
            "fax_number": "860-586-2114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNICOS",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000338",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CT",
            "license": "000338",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.