Individual provider Active NPI

Lisa Tuchman, M.D., MPH

  • Pediatric Adolescent Medicine Physician
  • Washington, DC
National Provider Identifier
1043403108
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD 038304 Issued in DC
Practice address
111 Michigan Ave NW
6TH Floor Main, Cri/CTS
Washington, DC 20010-2916
Phone
(202) 476-6481
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MD 038304 DC Primary
Pediatric Adolescent Medicine Physician 2080A0000X D0074672 MD

Addresses

Primary practice location

111 Michigan Ave NW
6TH Floor Main, Cri/CTS
Washington, DC 20010-2916

Mailing address

111 Michigan Ave NW
6TH Floor Main, Cri/CTS
Washington, DC 20010-2916
Phone (202) 476-6481

Other identifiers 1

IdentifierTypeStateIssuer
027980100MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20100419000485 DC Practitioner - Pediatric Medicine 3375630254 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 038304DCMDPediatric Adolescent Medicine Physician
D0074672MDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Current Accepting new patients
Children's Hospital CurrentSince Jan 23, 2010 Accepting new patients
Children's Hospital CurrentSince Jan 23, 2010 Accepting new patients
Pathlight Neuropsychiatric Center LLC PastSince May 14, 2023 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

111 Michigan Ave NW
Fl 6
Washington, DC 20010
Phone (202) 476-4455

Interoperability endpoints

  • Direct secure messaging: lisa.tuchman.p1@direct.mcg-hhs.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1043403108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "address_2": "6TH FLOOR MAIN, CRI/CTS",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "address_2": "6TH FLOOR MAIN, CRI/CTS",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCHMAN",
        "first_name": "LISA",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "DC",
            "license": "MD 038304",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0074672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027980100",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.