NPIMap

Individual provider Active NPI

Lisa Joan Nelson, PA

  • Medical Physician Assistant
  • Geneva, NY
National Provider Identifier
1053065680
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
029049 Issued in NY
Practice address
789 Pre Emption Rd
Geneva, NY 14456-2069
Phone
(315) 781-2000
NPI assigned
Feb 11, 2022
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 029049 NY Primary

Addresses

Primary practice location

789 Pre Emption Rd
Geneva, NY 14456-2069

Mailing address

601B W Washington St
Geneva, NY 14456-2119
Phone (315) 787-8151

Other practice location 1

65 W 36th St
New York, NY 10018-7902
Phone (888) 412-3632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221229001543 NY Practitioner - Physician Assistant 8022488436 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Finger Lakes Community HealthGroup PAC ID 0244251486, 14 clinicians
FLH Medical PCGroup PAC ID 6507922358, 47 clinicians

Practice addresses (Care Compare)

112 Kimball Ave
Penn Yan, NY 14527-1816
Phone (315) 536-2752

141 Central Ave
Keuka Park, NY 14478-9764
Phone (315) 279-5368

418 N Main St
Penn Yan, NY 14527-1070
Phone (315) 531-2000

601 B W Washington St
Geneva, NY 14456-2119
Phone (315) 781-8448

789 Pre Emption Rd
Suite 600
Geneva, NY 14456-2069
Phone (315) 781-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029049NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Soldiers & Sailors Memorial Hospital CurrentSince Jan 3, 2025 Accepting new patients
FLH Medical, PC CurrentSince Jan 3, 2025 Accepting new patients
Finger Lakes Community Health CurrentSince Dec 5, 2022 Accepting new patients
Finger Lakes Community Health CurrentSince Dec 5, 2022 Accepting new patients
Circle Medical Care of New York PC CurrentSince Aug 2, 2025 Accepting new patients
Soldiers & Sailors Memorial Hospital CurrentSince Jan 3, 2025 Accepting new patients
FLH Medical, PC Past Accepting new patients

Locations

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

601B W Washington St
Geneva, NY 14456
Phone (315) 781-8448

141 Central Ave
Keuka Park, NY 14478
Phone (315) 279-5000

156 William St
Rm 303
New York, NY 10038
Phone (813) 955-6329

112 Kimball Ave
Penn Yan, NY 14527
Phone (315) 531-9102

418 N Main St
Penn Yan, NY 14527
Phone (315) 531-2000

28 Cayuga St
Seneca Falls, NY 13148
Phone (315) 568-4415

Interoperability endpoints

  • Direct secure messaging: lisa.nelson@flch.eclinicaldirectplus.com

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1053065680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601B W WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562119",
            "telephone_number": "315-787-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 PRE EMPTION RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562069",
            "telephone_number": "315-781-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 W 36th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100187902",
            "country_code": "US",
            "telephone_number": "888-412-3632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LISA",
        "middle_name": "JOAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "029049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.