Lisa Domagala, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

008065-1 Issued in NY

Practice address

500 Sterling Dr
Orchard Park, NY 14127-1573

Phone

(716) 677-2273

Fax

(716) 677-2256

NPI assigned

Aug 31, 2006

Last updated

Aug 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Mulhisen Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Great Lakes Physician PCGroup PAC ID 9133434269, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Merit-based Incentive Payment System (MIPS)

Final score

75.58 of 100Reported as group

Quality

39.81

Promoting interoperability

88

Improvement activities

40

Cost

83.34

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ldomagala@qualitycare.medentdirect.com

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.

• Great Lakes Physician, PC

  • Urology Physician
  • Cheektowaga, NY
  • NPI 1659310092
  Medicare reassignment Care Compare group
• Great Lakes Urology PLLC

  • Urology Physician
  • Cheektowaga, NY
  • NPI 1063203859
  Medicare reassignment
• Great Lakes Physician, PC

  • Urology Physician
  • Cheektowaga, NY
  • NPI 1720045792
  NPD
• Buffalo Thoracic Surgical Associates PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Buffalo, NY
  • NPI 1659414605
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1083726251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 STERLING DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271573",
            "telephone_number": "716-677-2273",
            "fax_number": "716-677-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STERLING DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271573",
            "telephone_number": "716-677-2273",
            "fax_number": "716-677-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAGALA",
        "first_name": "LISA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008065-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MULHISEN",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carolyn Marie Doerr, PHARM D.
• Mark J Doerr, MD
• Danielle Angela Dolan, MS OTR/L
• Jeffrey Mark Dolgos, DDS
• Sarah Marie Dolph
• Cheryl Lynn Domanick, R.PH.
• Jacqueline A Dombrowski, MD
• Fernando B Domondon Jr., MD
• Jaclyn M Domroes, PA
• Jessica Anne Dorsey, L.M.T.

• Medical Physician Assistant in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.