Individual provider Active NPI

Lisa Ann Vignogna, MD

  • Emergency Medicine Physician
  • Syracuse, NY
National Provider Identifier
1033280037
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
207315 Issued in NY
Practice address
750 East Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-4363
Fax
(315) 464-8690
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 207315 NY Primary

Addresses

Primary practice location

750 East Adams St
Syracuse, NY 13210-2306

Mailing address

750 East Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4363

Other identifiers 1

IdentifierTypeStateIssuer
02164854MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071231000004 NY Practitioner - Emergency Medicine 8426138637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1919 Hempstead Tpke
East Meadow, NY 11554-1710
Phone (516) 227-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207315NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jul 24, 2020 Accepting new patients
Upstate Emergency Medicine, Inc Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Mar 3, 2014 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jul 24, 2020 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Crouse Health Hospital Inc Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Southwest ENT Associates PA Past Accepting new patients
Southwest ENT Associates PA PastSince Mar 23, 2009 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

1919 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 227-2273

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Ste 2
Manhasset, NY 11030
Phone (516) 562-3590

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

300 Community Dr
Plandome, NY 11030

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: lisa.vignogna.barlas.1@2983.direct.athenahealth.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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1033280037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGNOGNA",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "207315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02164854",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.