Lisa Pan, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT025572 Issued in PA

Practice address

331 Wilmington Pike
Glen Mills, PA 19342-2277

Phone

(610) 558-5866

Fax

(610) 558-6103

NPI assigned

Oct 11, 2016

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

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Luna Care Physical Therapy LLC 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Virginia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Fairfax, VA
  • NPI 1235720848

  DC, Orthopedic

  Medicare reassignment Care Compare group NPD
• Back in Motion Physical Therapy LLC

  • Physical Therapist
  • Lorton, VA
  • NPI 1992730469

  DC

  Medicare reassignment NPD
• Physical Therapy Your Way PLLC

  • Physical Therapy Clinic/Center
  • Lorton, VA
  • NPI 1245741024

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1104376417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W GERMANTOWN PIKE",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621420",
            "telephone_number": "610-270-0370",
            "fax_number": "610-270-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 WILMINGTON PIKE",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193422277",
            "telephone_number": "610-558-5866",
            "fax_number": "610-558-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT025572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oralfacial Dental Implant Surgery Center
• Orthopedic and Sports Physical Therapy Services, Inc.
• Gary Mitchell Owens, M.D.
• P Sabanayagam MD PC
• Robert Joseph Palladino Jr., M ED
• Molly Pandola, CRNP
• Kathleen Pankowski, PT
• Michelle Pantano, FNP
• Robert Martin Paolino, DMD
• Brad Andrew Papson, PT

• All providers in Glen Mills, PA
• Orthopedic Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.