Lisa M Dimenna, RN, NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

RN105827 Issued in AZ

Practice address

1501 N Campbell Ave
3341
Tucson, AZ 85724-5073

Phone

(520) 626-6627

Fax

(520) 626-5009

NPI assigned

Mar 18, 2009

Last updated

Jul 27, 2010By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427
  Medicare reassignment NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1013158195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "address_2": "PO BOX 245073",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245073",
            "telephone_number": "520-626-6627",
            "fax_number": "520-626-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "address_2": "3341",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245073",
            "telephone_number": "520-626-6627",
            "fax_number": "520-626-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMENNA",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "RN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "AZ",
            "license": "RN105827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Dillon, LCSW, LISAC
• R Christopher Dillon, M.D.
• Brittney Dimaggio, MD
• Lauren Dimalanta, MD
• David Dimcheff, MD
• Chelsa Elise Dimond, MS, RDN
• Tobie Dimont, M. ED. LPC
• Moeen U. Din, M.D.
• Derek Dindal, PHARMD
• Mark Alan Dindal, D.M.D

• Critical Care Neonatal Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Critical Care Neonatal Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.