Lisa Siracusa, RPA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00315900 Issued in NJ

Practice address

305 Seguine Ave
Suite Two
Staten Island, NY 10309-3730

Phone

(718) 966-7009

Fax

(718) 948-7514

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Advanced Surgical Radiology LLCGroup PAC ID 8426279852, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Advanced Surgical Radiology LLC

  • Surgery Physician
  • Somerset, NJ
  • NPI 1336489913
  Medicare reassignment Care Compare group

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

• Robert Wood Johnson University Hospital, Inc

  • General Acute Care Hospital
  • New Brunswick, NJ
  • NPI 1346243375
  Care Compare affiliation

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1104072909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SEGUINE AVE",
            "address_2": "SUITE TWO",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093730",
            "telephone_number": "718-966-7009",
            "fax_number": "718-948-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SEGUINE AVE",
            "address_2": "SUITE TWO",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093730",
            "telephone_number": "718-966-7009",
            "fax_number": "718-948-7514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 Veronica Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "NJ",
            "postal_code": "088733491",
            "country_code": "US",
            "telephone_number": "732-640-5316",
            "fax_number": "800-689-2361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRACUSA",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "004641",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00315900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rabindra P Sinha, MD
• Elvira Sinodskaya
• Sioc@Bay St Optical Pavilion
• Sipa, PLLC
• Jennifer Ann Siracusa, MS., ED.
• Mariano Siragusa
• Mary Siragusa, RN
• Tara Siragusa, OTR/L
• Shalini Sirisena, PHYSICIAN ASSISTANT
• Sisters of Charity Health Care Systems NH Inc

• Surgical Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.