Lisa M Micik, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MP00136000 Issued in NJ

Practice address

1 W Ridgewood Ave
Suite 103
Paramus, NJ 07652-2359

Phone

(201) 857-4200

Fax

(201) 857-4199

NPI assigned

Aug 9, 2006

Last updated

Jun 17, 2014By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Dermatology and Skin Surgery LLCGroup PAC ID 5496897175, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.76 of 100Reported as group

Quality

98.38

Promoting interoperability

100

Improvement activities

40

Cost

70.83

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Center for Dermatology and Skin Surgery LLC

  • Dermatology Physician
  • Paramus, NJ
  • NPI 1194051243
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1003826157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE STE 103",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522361",
            "telephone_number": "201-857-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522359",
            "telephone_number": "201-857-4200",
            "fax_number": "201-857-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICIK",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010318",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "MP00136000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Robert Meyer, LCSW
• Michael Ast MD PC
• Michael C Gartner DO PC
• Michael Distefano, M.D., P.a.
• Michael Distefano, M.D., P.a. (Michael Distefano, M.D., P.A., Department of Physical Therapy)
• Kathleen Anne Mikullitz, M.A. CF- SLP
• Matthew Ira Milestone, DMD
• Millennium Healthcare Centers, LLC (Care One at The Cupola)
• Millennium Healthcare Centers, LLC (Care One at Ridgewood Avenue)
• Millennium Physical Therapy, LLC

• Physician Assistant in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.