Richard Dean Lisman, M.D.,F.A.C.S

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

131130 Issued in NY

Practice address

635 Park Ave
New York, NY 10021-6546

Phone

(212) 585-1405

Fax

(212) 585-1408

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 20, 2019 through Jun 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rlisman22028@nyumc.direct-ci.com
• Direct secure messaging: rlisman68943@northwell.direct-ci.com

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.

• Manhattan Eye Ear and Throat Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1922169689
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1043219900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216546",
            "telephone_number": "212-585-1405",
            "fax_number": "212-585-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216546",
            "telephone_number": "212-585-1405",
            "fax_number": "212-585-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISMAN",
        "first_name": "RICHARD",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.,F.A.C.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1311301",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "131130",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "131130",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "131130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lisk, MD
• Lauri Ann Liskin, MD
• Martha Liskow
• Kelsey Lisle, M.S.ED.
• Seth Lisle
• Gabrielle Lisnoff, LCSW
• Jessica Danielle Lisogorsky, M.S.
• Lyudmyla Lisovska
• Alexa Liss, MS, CCC-SLP
• Amy Rebecca Liss, MSN, RN, EDD

• Ophthalmic Plastic and Reconstructive Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.