Individual provider Active NPI

Lise Vincent, DPM

  • Podiatrist
  • New York, NY
National Provider Identifier
1104880228
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005480 Issued in NY
Practice address
280 Henry St
New York, NY 10002-4816
Phone
(212) 227-8401
Fax
(212) 227-8842
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N005480 NY Primary

Addresses

Primary practice location

280 Henry St
New York, NY 10002-4816

Mailing address

280 Henry St
New York, NY 10002-4816
Phone (212) 227-8401

Other identifiers 1

IdentifierTypeStateIssuer
02117320MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423001138 NY Practitioner - Podiatry 6406842400 Reassigns benefits to 1 organization
Practice locations: Baldwin, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Betances Health CenterGroup PAC ID 1658391578, 18 clinicians

Practice addresses (Care Compare)

280 Henry St
New York, NY 10002-5808
Phone (212) 227-8401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005480NYMDOptometrist
N005480NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Betances Health Center Past Accepting new patients
Downstate Foot and Ankle Podiatry, PC Podiatrist Past Accepting new patients
Avenue U Footcare PastSince Jun 1, 1992 Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: lise.vincent@bhcnyc.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1104880228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 HENRY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024816",
            "telephone_number": "212-227-8401",
            "fax_number": "212-227-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 HENRY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024816",
            "telephone_number": "212-227-8401",
            "fax_number": "212-227-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "LISE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02117320",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.