NPIMap

Individual provider Active NPI

Lisa Diane Noe, PA

  • Medical Physician Assistant
  • Cushing, OK
National Provider Identifier
1063566743
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1499 Issued in OK
Practice address
1030 E Cherry St
Cushing, OK 74023-4102
Phone
(918) 225-0616
Fax
(918) 225-3740
NPI assigned
Jan 22, 2007
Last updated
May 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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 1499 OK Primary

Addresses

Primary practice location

1030 E Cherry St
Cushing, OK 74023-4102

Mailing address

1030 E Cherry St
Cushing, OK 74023-4102
Phone (918) 225-0616

Other identifiers 1

IdentifierTypeStateIssuer
200075990AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20060310000561 OK Practitioner - Physician Assistant 9931116324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1002 E Cherry St
Cushing, OK 74023-4102
Phone (918) 306-4515

1030 E Cherry St
Cushing Family Practice
Cushing, OK 74023-4102
Phone (918) 725-1901

417 Fairview Ave
Ponca City, OK 74601-1923
Phone (580) 762-3770

518 E Lakeview Rd
Stillwater, OK 74075-2825
Phone (405) 533-8990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1499OKMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince May 1, 2019 Accepting new patients
Stillwater Medical Center Authority Current Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients
Stillwater Medical Center Physicians Past Accepting new patients
Ahs Cushing Hospital LLC Past Accepting new patients

Locations

1030 E Cherry St
Cushing, OK 74023
Phone (918) 225-0616

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

Interoperability endpoints

  • Direct secure messaging: lisa.noe.p1@direct.smc.nextgenshare.com

Organizations & group practices 5

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 5

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1063566743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E CHERRY ST",
            "city": "CUSHING",
            "state": "OK",
            "postal_code": "740234102",
            "telephone_number": "918-225-0616",
            "fax_number": "918-225-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E CHERRY ST",
            "city": "CUSHING",
            "state": "OK",
            "postal_code": "740234102",
            "telephone_number": "918-225-0616",
            "fax_number": "918-225-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOE",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cushing, OK

Sources for this page

Verify at the official NPI Registry.