Active NPI
Lisa Douglass Lystad, MD
- Ophthalmology Physician
- Beachwood, OH
National Provider Identifier
1023089232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 35061509L
- Practice address
- 23250 Chagrin Blvd
BLD 5 Ste 440
Beachwood, OH 44122 - Phone
- (216) 514-1864
- Fax
- (216) 514-1867
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 35061509L | OH | Primary |
Addresses
Primary practice location
23250 Chagrin Blvd
BLD 5 Ste 440
Beachwood, OH 44122
Mailing address
23250 Chagrin Blvd #5
BLDG #5 Suite 440
Beachwood, OH 44122
Phone (216) 514-1864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0884593 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35061509L | OH | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Euclid Hospital Cleveland Clinic Health System | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Western Reserve Ophthalmology Inc | Ophthalmology | Past | Accepting new patients |
Interoperability endpoints
- llystad59255@direct.ccf.org
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Euclid, OH
- NPI 1457403016
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Ophthalmology Physician
- Beachwood, OH
- NPI 1649481177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023089232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23250 CHAGRIN BLVD #5",
"address_2": "BLDG #5 SUITE 440",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "44122",
"telephone_number": "216-514-1864",
"fax_number": "216-514-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23250 CHAGRIN BLVD",
"address_2": "BLD 5 STE 440",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "44122",
"telephone_number": "216-514-1864",
"fax_number": "216-514-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYSTAD",
"first_name": "LISA",
"middle_name": "DOUGLASS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "35061509L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0884593",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.