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LISA MARIE KEOVONGSA RD, LDN
NPI 1750859286
Dietitian, Registered in Arlington, MA

Active since November 02, 2018
30 STANDISH RD, ARLINGTON, MA 02476(781) 430-9833 Get Directions Write a Review

NPPES record last updated: October 6, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 6, 2023, Nov 2, 2018 (2 updates tracked since 2018).

About Lisa Marie Keovongsa Rd, Ldn NPPES

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

LISA MARIE KEOVONGSA RD, LDN (NPI 1750859286) is an individual dietitian, registered in Arlington, Massachusetts, licensed in Massachusetts (4706) and active in the NPI registry since November 2018.

NPPES Registry Identity

NPI1750859286
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameLISA MARIE KEOVONGSACredential: RD, LDN
Location Address30 STANDISH RDArlington, MA 02476-7069
Mailing Address30 Standish RdArlington, MA 02476-7069 · (781) 430-9833
Phone(781) 430-9833
Sole ProprietorYes
Enumeration DateNovember 2, 2018
Last NPPES UpdateOctober 6, 20232 updates tracked since enumeration
NPPES CertifiedOctober 6, 2023
✔ NPI 1750859286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MA · 4706
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
30 STANDISH RD, Arlington, MA 02476
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Marie Keovongsa Rd, Ldn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Lisa Keovongsa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Actualize Counseling & Nutrition LLC
Same address
Clinical
30 STANDISH RD
Arlington, MA 02476
  • Reassigned Medicare billing, Massachusetts enrollment
  • 4 clinicians in this Medicare group
NPI 1316571136 (781) 430-9833

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

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

KHAMPHADY KEOVONGSA LICSW
Social Worker (Clinical)
30 STANDISH RD
ARLINGTON, MA 02476
Middlesex County (781) 999-4975
ACTUALIZE COUNSELING & NUTRITION LLC
Social Worker (Clinical)
30 STANDISH RD
ARLINGTON, MA 02476
Middlesex County (781) 430-9833
VANESSA JEANNETTE BEAUREGARD
Dietitian, Registered
30 STANDISH RD
ARLINGTON, MA 02476
Middlesex County (781) 999-4975
CATHERINE VERDERA
Counselor (Mental Health)
30 STANDISH RD
ARLINGTON, MA 02476
Middlesex County (857) 847-3526
ALEXANDRA CAROLINE MCARTHUR-KEWENE
Social Worker (Clinical)
30 STANDISH RD
ARLINGTON, MA 02476
Middlesex County (781) 999-4975

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Keovongsa's NPI number?

The NPI number for Lisa Keovongsa is 1750859286. It was assigned to this individual provider in the NPPES registry on November 2, 2018.

Where is Lisa Keovongsa located?

Lisa Keovongsa practices at 30 Standish Rd, Arlington, MA 02476. The listed phone number is (781) 430-9833.

What is Lisa Keovongsa's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Lisa Keovongsa enrolled in Medicare?

Yes. Lisa Keovongsa is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Keovongsa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Keovongsa reassigns Medicare benefits to Actualize Counseling & Nutrition LLC (Arlington, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Keovongsa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Keovongsa accept?

Health plans from Anthem Blue Cross and Blue Shield list Lisa Keovongsa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Keovongsa was last updated on October 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.