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DR. LISA MARIE FAHEY M.D.
NPI 1356631543
Pediatrics - Pediatric Gastroenterology in Philadelphia, PA

Active since April 09, 2011PECOS EnrolledAccepts Medicare Assignment
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC GASTROENTEROLOGY, PHILADELPHIA, PA 19104(215) 590-3630 Get Directions Write a Review

NPPES record last updated: May 10, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Lisa Marie Fahey M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA MARIE FAHEY M.D. (NPI 1356631543) is an individual pediatric gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT205490) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2011).

NPPES Registry Identity

NPI1356631543
Entity TypeIndividualFemale
Primary Taxonomy2080P0206X
Provider Legal NameDR. LISA MARIE FAHEYCredential: M.D.
Location Address3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC GASTROENTEROLOGYPhiladelphia, PA 19104-4319
Mailing Address3401 Civic Center Blvd, Division Of GastroenterologyPhiladelphia, PA 19104-4319 · (215) 590-3600
Phone(215) 590-3630
Sole ProprietorNo
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2011
Enumeration DateApril 9, 2011
Last NPPES UpdateMay 10, 2015
✔ NPI 1356631543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
License✔ Licensed in PA · MT205490
Definition

A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Lisa Marie Fahey M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991124703
PECOS Enrollment IDI20200929000332
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH A JAMME MD
Pediatrics
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
MEENA THAYU M.D.
Pediatrics (Pediatric Gastroenterology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
RICHARD M DONNER M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
MARIANNE M GLANZMAN M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ABIGAIL F FARBER M.D.
Pediatrics
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
BEVERLY J LANGE M.D.
Pediatrics (Pediatric Hematology-Oncology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
PAUL J HONIG M.D.
Dermatology
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ROSANNA POLLACK CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, 4TH FLOOR WOOD BUILDING
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4953

Frequently Asked Questions

What is Lisa Fahey's NPI number?

The NPI number assigned to this healthcare provider is 1356631543, enumerated as an "individual" on April 09, 2011.

Where is the provider located?

The provider is located at 3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC GASTROENTEROLOGY PHILADELPHIA, PA 19104 and the phone number is (215) 590-3630.

What is the provider's specialty?

Pediatrics with taxonomy code 2080P0206X and a focus in Pediatric Gastroenterology.