Active NPI
Lisa Pedota, M.S.
- Health Educator
- Mastic, NY
National Provider Identifier
1053747360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 11 Burney Blvd
Mastic, NY 11950-1301 - Phone
- (631) 258-0983
- Fax
- (631) 258-0983
- NPI assigned
- Sep 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
11 Burney Blvd
Mastic, NY 11950-1301
Mailing address
11 Burney Blvd
Mastic, NY 11950-1301
Phone (631) 258-0983
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1053747360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 BURNEY BLVD",
"city": "MASTIC",
"state": "NY",
"postal_code": "119501301",
"telephone_number": "631-258-0983",
"fax_number": "631-258-0983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 BURNEY BLVD",
"city": "MASTIC",
"state": "NY",
"postal_code": "119501301",
"telephone_number": "631-258-0983",
"fax_number": "631-258-0983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDOTA",
"first_name": "LISA",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-18",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mastic, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.