David P. Lisbon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD473063 Issued in PA

Practice address

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Phone

(570) 808-7762

Fax

(570) 808-7762

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1336730449

  Corporate Director

  CMS ownership
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1437817830

  Corporate Director

  CMS ownership
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Independence, MO
  • NPI 1477648327

  Corporate Director

  CMS ownership
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1548993942

  Corporate Director

  CMS ownership
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1689760076

  Corporate Director

  CMS ownership

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Lock Haven, PA
  • NPI 1144876137
  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Clarks Summit, PA
  • NPI 1972910354
  NPD
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1073075909
  NPD

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1083716237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-7762",
            "fax_number": "570-808-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISBON",
        "first_name": "DAVID",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-29512",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-29512",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD473063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHP PROVIDER NUMBER",
            "identifier": "10001612201",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200267750A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5640019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC PROVIDER NUMBER",
            "identifier": "21474034",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSKU TAX ID",
            "identifier": "481202402",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202299129",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "306302",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00193174",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Liguori, DPT
• D'Andra Marie Lindbuchler
• Anthony Paul Linnen, LCSW
• Leane E. Lipinski-Delbalso, O.D.
• Elisabeth Lipperini, CRNP
• Susan Lynn Liskowicz, PA-C
• Arthur Liss, M.D.
• Little Flower Manor
• Nicole Littzi, LPN
• Michele Litzenbauer

• Emergency Medicine Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.