Individual provider Active NPI

Lisa Ann Cuseo-Ott, PH.D.

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1073531299
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001927 Issued in VA
Practice address
12129 Graham Meadows Dr
Richmond, VA 23233-6661
Phone
(804) 288-4084
Fax
(804) 282-2601
NPI assigned
Jul 17, 2006
Last updated
Apr 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810001927 VA Primary

Addresses

Primary practice location

12129 Graham Meadows Dr
Richmond, VA 23233-6661

Mailing address

7130 Glen Forest Dr
Suite 101
Richmond, VA 23226-3754
Phone (804) 288-4084

Other identifiers 1

IdentifierTypeStateIssuer
1073531299MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329001461 VA Practitioner - Clinical Psychologist 0244122620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

12129 Graham Meadows Dr
Richmond, VA 23233-6661
Phone (804) 288-4084

6600 W Broad St
Suite 100
Richmond, VA 23230-1709
Phone (804) 288-4087

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 18, 2018 Accepting new patients
Virginia Womens Center Inc CurrentSince Jan 1, 2011 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 18, 2018 Accepting new patients
Cardiovascular Associates of Virginia, P.C. Past Accepting new patients
Summit Health Care Inc Past Accepting new patients
Summit Health Care, Inc. Past Accepting new patients

Locations

930 South Ave
Ste 2
Colonial Hgts, VA 23834
Phone (804) 520-8272

8644 Sudley Rd
#220
Manassas, VA 20110

12129 Graham Meadows Dr
Richmond, VA 23233

5875 Bremo Rd
Ste 400
Richmond, VA 23226
Phone (804) 287-3550

7130 Glen Forest Dr
Ste 101
Richmond, VA 23226

Interoperability endpoints

  • Direct secure messaging: lisa.cuseo-ott.1@8042.direct.athenahealth.com

Organizations & group practices 6

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1073531299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 GLEN FOREST DR",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263754",
            "telephone_number": "804-288-4084",
            "fax_number": "804-282-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 GRAHAM MEADOWS DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232336661",
            "telephone_number": "804-288-4084",
            "fax_number": "804-282-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSEO-OTT",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073531299",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.