Lisa A Debernardi, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

2008030512 Issued in MO

Practice address

5108 Hampton Ave
Saint Louis, MO 63109-3113

Phone

(314) 821-3668

Fax

(888) 966-0079

NPI assigned

Jul 19, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Arch Podiatry LLC

  • Podiatrist
  • Florissant, MO
  • NPI 1831481910
  NPD (past)
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1043219215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093113",
            "telephone_number": "314-821-3668",
            "fax_number": "888-966-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093113",
            "telephone_number": "314-821-3668",
            "fax_number": "888-966-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERNARDI",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004789",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "MO",
            "license": "2008030512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004789",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043219215",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "1622982",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480014516",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01302982",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas F Debartolo, MD
• Ashley Kristin Debauge, MD
• Debbie Granick LCSW RN LLC
• Jordan Debeatham-Gaspard
• Traci R Debeir, RN, BSN
• Vincent Joseph Deblaze
• James Walton Debnam Jr., M.D.
• James W Deboard, MD
• Austin Robert Deboer, ATC
• Christine M Debold, ANP

• Primary Podiatric Medicine Podiatrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Primary Podiatric Medicine Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.