NPIMap

Individual provider Active NPI

Lisa Ratanaprasatporn, M.D.

  • Diagnostic Radiology Physician
  • Dallas, TX
National Provider Identifier
1033529508
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD483295 Issued in PA
Practice address
2825 Oak Lawn Ave Unit 19749
Dallas, TX 75219-4102
Phone
(510) 683-9500
Fax
(877) 880-2039
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
No

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD-23834 HI
Diagnostic Radiology Physician 2085R0202X 35.149295 OH
Diagnostic Radiology Physician 2085R0202X MD483295 PA Primary
Diagnostic Radiology Physician 2085R0202X C192021 CA

Addresses

Primary practice location

2825 Oak Lawn Ave Unit 19749
Dallas, TX 75219-4102

Mailing address

2825 Oak Lawn Ave Unit 19749
Dallas, TX 75219-4102
Phone (510) 683-9500

Other practice location 1

115 Lincoln St
Framingham, MA 01702-6358
Phone (347) 525-5294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231216000017 PA Practitioner - Diagnostic Radiology 2961717772 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Warren Alpert Medical School of Brown University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Radiology LLC 180 clinicians
Sutter Valley Medical Foundation 2,473 clinicians

Practice addresses (Care Compare)

1 Henley Dr
Glen Mills, PA 19342-2606
Phone (614) 293-8315

506 S 44TH St
Philadelphia, PA 19104-5292
Phone (614) 293-8315

Hospital & facility affiliations

  • Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C192021CAMDDiagnostic Radiology Physician
MD-23834HIMDDiagnostic Radiology Physician
35.149295OHMDDiagnostic Radiology Physician
MD483295PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Radiology Group Inc Diagnostic Radiology CurrentSince Dec 1, 2023 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jul 1, 2024 Accepting new patients
Sutter Valley Medical Foundation Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Metrowest Imaging Center LLC CurrentSince Mar 10, 2021 Accepting new patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Sutter Valley Medical Foundation Past Accepting new patients

Locations

1625 Stockton Blvd
Ste 207
Sacramento, CA 95816
Phone (916) 878-3495

321 N Kuakini St
Ste 405
Honolulu, HI 96817
Phone (808) 522-0190

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1033529508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 OAK LAWN AVE UNIT 19749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194102",
            "telephone_number": "510-683-9500",
            "fax_number": "877-880-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 OAK LAWN AVE UNIT 19749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194102",
            "telephone_number": "510-683-9500",
            "fax_number": "877-880-2039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017026358",
            "country_code": "US",
            "telephone_number": "347-525-5294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATANAPRASATPORN",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD-23834",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.149295",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD483295",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C192021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.