Lisa Mary Greenan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3465 Issued in AZ

Practice address

14155 N 83Rd Ave
Suite #110
Peoria, AZ 85381-5639

Phone

(623) 215-0911

Fax

(623) 215-0912

NPI assigned

Aug 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1053567032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE",
            "address_2": "SUITE #110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-215-0911",
            "fax_number": "623-215-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE",
            "address_2": "SUITE #110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-215-0911",
            "fax_number": "623-215-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAN",
        "first_name": "LISA",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Valley Behavioral Homes
• Anna C Green, D.D.S.
• Briana Lyn Green
• Diana Green
• Madison Green, PA-C
• Jeffrey M Greenberg, MD
• Bianca Greene
• Abigail Greenup
• Susan T Gregg, OTR/L
• Julie Greseth

• Physician Assistant in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.