NPIMap

Individual provider Active NPI

Lisa Elaine Brand, M.D.

  • Surgery Physician
  • Camarillo, CA
National Provider Identifier
1104178193
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A126474 Issued in CA
Practice address
4542 Las Posas Rd Ste D
Camarillo, CA 93010-2521
Phone
(805) 322-8490
Fax
(805) 586-8066
NPI assigned
Oct 15, 2012
Last updated
Nov 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A126474 CA Primary

Addresses

Primary practice location

4542 Las Posas Rd Ste D
Camarillo, CA 93010-2521

Mailing address

5235 Mission Oaks Blvd # 301
Camarillo, CA 93012-5400

Other names 1

  • Lisa Elaine Small Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816001479 CA Practitioner - General Surgery 2961796842 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4542 Las Posas Rd
Suite D
Camarillo, CA 93010-2521
Phone (805) 322-8490

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy11
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal1-10
Melanoma (skin cancer) excision15
Removal of tissue226
Removal of skin lesions1-10
Removal or shaving of skin growth17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126474CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital Surgery CurrentSince May 1, 2024 Accepting new patients
Ridgecrest Regional Hospital Current Accepting new patients
L E Brand, MD Corporation Surgery CurrentSince Jan 1, 2023 Accepting new patients
Neal P. Dixon, M.D., a General Surgical Medical Corporation Surgery CurrentSince Aug 1, 2016 Accepting new patients
Dignity Health Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Community Memorial Hospital Past Accepting new patients

Locations

2438 N Ponderosa Dr
Ste C207
Camarillo, CA 93010
Phone (805) 484-3513

4542 Las Posas Rd
Ste D
Camarillo, CA 93010
Phone (805) 322-8490

1011 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 499-3360

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

1111 N China Lake Blvd
#220
Ridgecrest, CA 93555
Phone (760) 446-8100

Interoperability endpoints

  • Direct secure messaging: leb102pcs@m842.primeclinicalsystems.direct-ci.com

Organizations & group practices 7

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 12

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": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1104178193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5235 MISSION OAKS BLVD # 301",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4542 LAS POSAS RD STE D",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102521",
            "telephone_number": "805-322-8490",
            "fax_number": "805-586-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "LISA",
        "middle_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A126474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SMALL",
            "middle_name": "ELAINE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.