Individual provider Active NPI

Lisa S. Williams, PA-C

  • Physician Assistant
  • Trumansburg, NY
National Provider Identifier
1013979632
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051580 Issued in PA
Practice address
9586 Ny Route 96
Trumansburg, NY 14886
Phone
(570) 269-1223
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051580 PA Primary

Addresses

Primary practice location

9586 Ny Route 96
Trumansburg, NY 14886

Mailing address

9586 Ny Route 96
Trumansburg, NY 14886
Phone (570) 269-1223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20200207002159 NY Practitioner - Physician Assistant 3971406893 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024426NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler Hospital Inc CurrentSince Aug 15, 2023 Accepting new patients
Nes Medical Services of New York PC CurrentSince Dec 14, 2019 Accepting new patients
Schuyler Hospital Inc CurrentSince Jan 14, 2026 Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant CurrentSince Dec 1, 2015 Accepting new patients
Schuyler Hospital Inc CurrentSince Aug 15, 2023 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Sep 3, 2013 Accepting new patients
Nes Medical Services of New York PC CurrentSince Dec 14, 2019 Accepting new patients
Pocono Emergency Physicians, P.C. Past Accepting new patients

Locations

7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

Interoperability endpoints

  • Direct secure messaging: lwilliams27474@direct.xtensys.com

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1013979632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9586 NY ROUTE 96",
            "city": "TRUMANSBURG",
            "state": "NY",
            "postal_code": "14886",
            "telephone_number": "570-269-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9586 NY ROUTE 96",
            "city": "TRUMANSBURG",
            "state": "NY",
            "postal_code": "14886",
            "telephone_number": "570-269-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LISA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumansburg, NY

Sources for this page

Verify at the official NPI Registry.