Individual provider Active NPI

Lisa Fouts Roupas, CRNP

  • Family Nurse Practitioner
  • York, PA
National Provider Identifier
1104009869
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009626 Issued in PA
Practice address
25 Monument Rd Ste 105
York, PA 17403-5049
Phone
(717) 851-7575
Fax
(717) 798-3702
NPI assigned
Dec 17, 2007
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP009626 PA Primary

Addresses

Primary practice location

25 Monument Rd Ste 105
York, PA 17403-5049

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-7575

Other names 1

  • Lisa Ann Fouts Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080118000093 PA Practitioner - Nurse Practitioner 8325129133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676
Phone (717) 851-4005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP009626PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince May 12, 2012 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jan 14, 2020 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services Nurse Practitioner CurrentSince Jan 14, 2020 Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

1001 S George St
Fl 4
York, PA 17403
Phone (717) 851-2417

1600 S George St
York, PA 17403
Phone (717) 848-3615

1601 S Queen St
York, PA 17403
Phone (717) 848-2067

1703 Innovation Dr
York, PA 17408
Phone (717) 741-3449

25 Monument Rd
Ste 105
York, PA 17403
Phone (717) 741-9345

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

3421 Concord Rd
Ste B3
York, PA 17402

Interoperability endpoints

  • Direct secure messaging: lroupas16078@wellspan.direct-ci.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 4

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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1104009869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-7575",
            "fax_number": "717-798-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONUMENT RD STE 105",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035049",
            "telephone_number": "717-851-7575",
            "fax_number": "717-798-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUPAS",
        "first_name": "LISA",
        "middle_name": "FOUTS",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "FOUTS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.