Lyceum Longevity Center Pllc - Medicare in Philadelphia, PA

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Lyceum Longevity Center Pllc is a medicare enrolled "Specialist" provider in Philadelphia, Pennsylvania. Their current practice location is 6062 Ridge Ave, Philadelphia, Pennsylvania. You can reach out to their office (for appointments etc.) via phone at (215) 508-5555.

Lyceum Longevity Center Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Lyceum Longevity Center Pllc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1831666585.

Contact Information

Lyceum Longevity Center Pllc
6062 Ridge Ave,
Philadelphia, PA 19128-1647
(215) 508-5555
(215) 508-5555

Map and Direction




Healthcare Provider's Profile

Full NameLyceum Longevity Center Pllc
TypeFacility
SpecialitySpecialist
Location6062 Ridge Ave, Philadelphia, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1831666585
  • Provider Enumeration Date: 10/31/2018
  • Last Update Date: 10/04/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 6800138082
  • Enrollment ID: O20190509000680

Medical Identifiers

Medical identifiers for Lyceum Longevity Center Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1831666585NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor (* (Not Available))Secondary
2085R0202XRadiology - Diagnostic Radiology (* (Not Available))Secondary
174400000XSpecialist (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lyceum Longevity Center Pllc acts as a billing entity for following providers:
Provider NameWilliam J Pezzello
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1720278740
PECOS PAC ID: 1557358819
Enrollment ID: I20090714000667
Provider NameMatthew P Cahill
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1528031325
PECOS PAC ID: 5698816619
Enrollment ID: I20100112000610
Provider NamePatricia Woods
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1760614655
PECOS PAC ID: 6901071430
Enrollment ID: I20111213000243
Provider NamePaul L Ezeukwu
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1326175936
PECOS PAC ID: 6406959352
Enrollment ID: I20180301000205
Provider NameGeenander K Raju
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356823959
PECOS PAC ID: 2567713738
Enrollment ID: I20180927000450
Provider NameJeffrey Anthony Gazzara
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1790135358
PECOS PAC ID: 9638443278
Enrollment ID: I20190814001560
Provider NameSamuel Schepart
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1528536901
PECOS PAC ID: 3173855590
Enrollment ID: I20191104001628
Provider NamePanya Asabi Henry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124681507
PECOS PAC ID: 8921433533
Enrollment ID: I20200108001770
Provider NameVirginia Dennis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326717711
PECOS PAC ID: 1355711466
Enrollment ID: I20230106001273

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lyceum Longevity Center Pllc is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lyceum Longevity Center Pllc
6062 Ridge Ave,
Philadelphia, PA 19128-1647

Ph: (215) 508-5555		Lyceum Longevity Center Pllc
6062 Ridge Ave,
Philadelphia, PA 19128-1647

Ph: (215) 508-5555

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.