Andrew Lisitsky

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

65461 Issued in OR

Practice address

17885 NE Evergreen Parkway
Ste 220
Beaverton, OR 97006

Phone

(503) 571-3366

NPI assigned

Mar 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Stride Physio PLLC

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1750703567
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• South Salem Rehabilitation, LLC

  • Skilled Nursing Facility
  • Salem, OR
  • NPI 1215071998
  NPD
• Manor Care of Salmon Creek Wa, Association

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1609171081
  NPD
• Morgan Kriz PLLC

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1194360255

  Physical Therapist

  NPD
• Lake Washington Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Kirkland, WA
  • NPI 1770894990

  Physical Therapist

  NPD (past)
• T&M Physical Therapy PLLC Dba Lake Erie Physical Therapy

  • Physical Therapist
  • Buffalo, NY
  • NPI 1225754708
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1104887587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 DIVISION ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204464",
            "telephone_number": "716-693-0556",
            "fax_number": "866-907-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17885 NE EVERGREEN PARKWAY",
            "address_2": "STE 220",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "503-571-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Division St",
            "address_purpose": "LOCATION",
            "city": "North Tonawanda",
            "state": "NY",
            "postal_code": "141204464",
            "country_code": "US",
            "telephone_number": "716-693-0556",
            "fax_number": "866-907-6157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11800 NE 128th St",
            "address_2": "STE. 400",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980347208",
            "country_code": "US",
            "telephone_number": "425-820-0869",
            "fax_number": "425-820-1745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISITSKY",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65461",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023017",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "7587LI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5479LI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "7588LI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0219769",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lauren Little, DPT
• Chuyi Liu, BCBA

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.