Active NPI
Lisa Elaine Medwedeff, M.D.
- Internal Medicine Physician
- Plano, TX
National Provider Identifier
1104827799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- K1257
- Practice address
- 5425 W Spring Creek Parkway Suite 210
Plano, TX 75024 - Phone
- (972) 608-3333
- Fax
- (972) 473-7333
- NPI assigned
- Aug 3, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | K1257 | TX | |
| Internal Medicine Physician | 207R00000X | K1257 | TX | Primary |
Addresses
Primary practice location
5425 W Spring Creek Parkway Suite 210
Plano, TX 75024
Mailing address
5425 W Spring Creek Parkway Suite 210
Plano, TX 75024
Phone (972) 608-3333
Other practice location 1
465 W President George Bush Hwy Ste 240
Richardson, TX 75080-1188
Phone (469) 677-0267
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0299083-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Texas Southwestern Medical School at Dallas, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5425 W Spring Creek Pkwy
Suite 210
Plano, TX 75024-4241
Hospital & facility affiliations
- Optimum Home Health Care Inc
- Medical City Plano
- Texas Health Presbyterian Hospital Plano
- Medical Center of McKinney
- Texas Health Presbyterian Hospital Allen
- Medical City Dallas Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lisa Medwedeff M.D. PA | Current | Accepting new patients |
Locations
5425 W Spring Creek Pkwy
Ste 210
Plano, TX 75024
Phone (972) 608-3333
465 W President George Bush Hwy
Ste 240
Richardson, TX 75080
Phone (469) 677-0267
Interoperability endpoints
- lisa.medwedeff@lem.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/IGBGCA/Endpoint/IGBGCA
Organizations & group practices 1
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.
-
- Specialist
- Plano, TX
- NPI 1982843769
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1023180502
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1689628984
-
- General Acute Care Hospital
- McKinney, TX
- NPI 1437102639
-
- General Acute Care Hospital
- Plano, TX
- NPI 1699726406
-
- Home Health Agency
- Plano, TX
- NPI 1487605598
-
- General Acute Care Hospital
- Allen, TX
- NPI 1548291883
-
- General Acute Care Hospital
- Plano, TX
- NPI 1770514077
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1104827799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5425 W SPRING CREEK PARKWAY SUITE 210",
"city": "PLANO",
"state": "TX",
"postal_code": "75024",
"telephone_number": "972-608-3333",
"fax_number": "972-473-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5425 W SPRING CREEK PARKWAY SUITE 210",
"city": "PLANO",
"state": "TX",
"postal_code": "75024",
"telephone_number": "972-608-3333",
"fax_number": "972-473-7333"
}
],
"practiceLocations": [
{
"address_1": "465 W President George Bush Hwy Ste 240",
"address_purpose": "LOCATION",
"city": "Richardson",
"state": "TX",
"postal_code": "750801188",
"country_code": "US",
"telephone_number": "469-677-0267",
"fax_number": "469-677-0247",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDWEDEFF",
"first_name": "LISA",
"middle_name": "ELAINE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-03",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "TX",
"license": "K1257",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "K1257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0299083-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.