Individual provider Active NPI

Lisa Wilson, CRNP

  • Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1023301983
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN273527 Issued in MA
Practice address
200 Lothrop St
Pittsburgh, PA 15213-2536
Phone
(412) 647-5909
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP011261 PA
Nurse Practitioner 363L00000X RN273527 MA Primary

Addresses

Primary practice location

200 Lothrop St
Pittsburgh, PA 15213-2536

Mailing address

200 Lothrop St
Forbes Tower, Suite 9055
Pittsburgh, PA 15213-2536

Other names 1

  • Lisa Belletete Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170403001178 MA Practitioner - Nurse Practitioner 5395922652 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Mar 7, 2017 Accepting new patients
Lahey Clinic, Inc. CurrentSince Mar 7, 2017 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

Interoperability endpoints

  • Direct secure messaging: lwilson26859@tuftsmedicine.direct-ci.com

Organizations & group practices 2

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1023301983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST",
            "address_2": "FORBES TOWER, SUITE 9055",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536",
            "telephone_number": "412-647-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LISA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP011261",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN273527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BELLETETE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.