Kenneth M. Lyssy Jr MD PA
NPI 1205039559 · Family Medicine Physician · San Antonio, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenneth M. Lyssy Jr MD PA is a Family Medicine Physician organization in San Antonio, TX (NPI 1205039559).
Provider details
- NPI number
- 1205039559
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Melissa Souhrada, Office Manager(210) 256-9500
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Dr Kenneth M Lyssy Jr MD
Registry dates
- Enumerated
- 2007-06-06
- Last updated
- 2008-07-02
Frequently asked questions
- What is Kenneth M. Lyssy Jr MD PA's NPI number?
- Kenneth M. Lyssy Jr MD PA's National Provider Identifier (NPI) is 1205039559, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kenneth M. Lyssy Jr MD PA?
- Kenneth M. Lyssy Jr MD PA is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Kenneth M. Lyssy Jr MD PA located?
- Kenneth M. Lyssy Jr MD PA's practice location on file with NPPES is 6100 Bandera Rd, San Antonio, TX 78238-1652.
- What is Kenneth M. Lyssy Jr MD PA's phone number?
- The practice phone number listed in the NPPES registry for Kenneth M. Lyssy Jr MD PA is (210) 256-9500.
- Does Kenneth M. Lyssy Jr MD PA accept Medicare?
- Kenneth M. Lyssy Jr MD PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kenneth M. Lyssy Jr MD PA?
- The authorized official listed on Kenneth M. Lyssy Jr MD PA's NPPES record is Melissa Souhrada, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kenneth M. Lyssy Jr MD PA's NPI active?
- Yes — Kenneth M. Lyssy Jr MD PA's NPI (1205039559) is active in the NPPES registry as of the last update on 2008-07-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.