Lisa A Mesaros, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60125666 Issued in WA

Practice address

931 S Market Blvd
PMG SW Wa Chehalis Family Medicine
Chehalis, WA 98532-3423

Phone

(360) 767-6300

NPI assigned

Feb 7, 2008

Last updated

Mar 13, 2014By 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 2

Addresses

Other names 1

• Lisa A Nicholas Other name

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006
• St Luke's Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmesaros22609@direct.slhs.org

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes West LTD

  dba St Lukes Nampa Medical Center

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1033397450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "address_2": "PMG SW WA",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 S MARKET BLVD",
            "address_2": "PMG SW WA CHEHALIS FAMILY MEDICINE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323423",
            "telephone_number": "360-767-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESAROS",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002085",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60125666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "NICHOLAS",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Medical Massage & Acupuncture, P.S. (Chehalis Naturopathic Medicine)
• Aida Dolores Mendez
• Bella Luz Mendez, B.A.
• Mark Charles Mercer, L.D.
• Louann Mercier, DDS
• Michael a White DDS PS
• Hannah Gene Middleton, OTA
• Brian Miller, M.S.
• Donald Rex Miller, MD
• Shayla Miller

• Physician Assistant in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.