Lisa A Tomsak, DO

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

25MB11582500 Issued in NJ

Practice address

1590 S Congress Ave
Palm Springs, FL 33406-5957

Phone

(570) 466-5757

NPI assigned

Aug 31, 2005

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 10

Addresses

Other identifiers 1

Other names 1

• Lisa A Costaris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CMJ Recovery Az LLC

  • Psychiatric Hospital
  • Phoenix, AZ
  • NPI 1558988246
  NPD (past)
• CMJ Recovery NV LLC

  dba Vogue Recovery Center Nevada

  • Substance Abuse Rehabilitation Facility
  • Las Vegas, NV
  • NPI 1932727096
  NPD (past)
• Royal Az LLC

  dba Royal Life Centers

  • Psychiatric Hospital
  • Prescott, AZ
  • NPI 1013668219
  NPD (past)
• Royal Az LLC

  dba Royal Life Centers

  • Psychiatric Hospital
  • Prescott, AZ
  • NPI 1861258550
  NPD (past)
• Royal Life Centers, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mead, WA
  • NPI 1285089540
  NPD (past)
• Royal Wa Sumner LLC

  • Psychiatric Hospital
  • Sumner, WA
  • NPI 1477204683
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1003809450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 ARTESA DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334362628",
            "telephone_number": "570-466-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 S CONGRESS AVE",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334065957",
            "telephone_number": "570-466-5757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 W River Rd",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601231570",
            "country_code": "US",
            "telephone_number": "847-281-5394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6505 S Paris St",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801116503",
            "country_code": "US",
            "telephone_number": "720-571-0022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Quakerbridge Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "NJ",
            "postal_code": "086191200",
            "country_code": "US",
            "telephone_number": "609-249-4641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMSAK",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "PA",
            "license": "OS007618L",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036162516",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "IN",
            "license": "02005078A",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "FL",
            "license": "OS14219",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "AZ",
            "license": "007179",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "WA",
            "license": "OP60707874",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NJ",
            "license": "25MB11582500",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CO",
            "license": "DR.0068878",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NV",
            "license": "DO3188",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "18636",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013931090006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "COSTARIS",
            "middle_name": "A",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon A Thrush, APRN
• Meriah Faith Tims
• Catalina Tobon Orozco
• Melanie Tolchin, MSW
• Roxana Toledo Guerra
• Nikita Roshell Tookes, MA
• Yordain Torres Alfonso
• Karina Torres Duenas, RBT
• Lisette Torres More
• Katia Torres Santiesteban

• Addiction Medicine (Internal Medicine) Physician in Palm Springs, FL
• Providers in Palm Springs, FL by specialty
• Addiction Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.