Individual provider Active NPI

Lisa Pattanayak, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1073686234
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME82411 Issued in FL
Practice address
1106 Lucerne Ter
Orlando, FL 32806-1017
Phone
(407) 316-8898
Fax
(407) 540-0773
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME82411 FL Primary

Addresses

Primary practice location

1106 Lucerne Ter
Orlando, FL 32806-1017

Mailing address

1106 Lucerne Ter
Orlando, FL 32806-1017
Phone (407) 316-8898

Other practice location 1

6150 Metrowest Blvd Ste 307
Orlando, FL 32835-3291
Phone (407) 294-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041122001266 FL Practitioner - Internal Medicine 5698730331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Health IncGroup PAC ID 2365406840, 11 clinicians

Practice addresses (Care Compare)

6150 Metrowest Blvd
Suite 307
Orlando, FL 32835-3291
Phone (407) 294-1014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Health, Inc. Internal Medicine CurrentSince Sep 8, 2014 Accepting new patients

Locations

6150 Metrowest Blvd
Ste 307
Orlando, FL 32835
Phone (407) 294-1014

1106 Lucerne Ter
Orlando, FL 32806
Phone (407) 316-8898

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1073686234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 LUCERNE TER",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061017",
            "telephone_number": "407-316-8898",
            "fax_number": "407-540-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 LUCERNE TER",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061017",
            "telephone_number": "407-316-8898",
            "fax_number": "407-540-0773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6150 Metrowest Blvd Ste 307",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328353291",
            "country_code": "US",
            "telephone_number": "407-294-1014",
            "fax_number": "407-294-7732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTANAYAK",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME82411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.