Individual provider Active NPI

Lisa Michelle Hodge-Scelsa, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Patchogue, NY
National Provider Identifier
1104922244
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F301157 Issued in NY
Practice address
77 Medford Ave
Route 112
Patchogue, NY 11772-1281
Phone
(631) 758-4444
Fax
(631) 758-1984
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F301157 NY Primary

Addresses

Primary practice location

77 Medford Ave
Route 112
Patchogue, NY 11772-1281

Mailing address

280 Montauk Hwy
PO Box 9182
Bay Shore, NY 11706-8403
Phone (631) 758-4444

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110205000089 NY Practitioner - Nurse Practitioner 5890975031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 719-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F301157NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 12, 2016 Accepting new patients
South Shore Neurologic Associates P.C. Past Accepting new patients
South Shore Neurologic Associates, PC Past Accepting new patients
North Suffolk Cardiology Associates PastSince Jul 7, 2008 Accepting new patients

Locations

280 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 666-3939

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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.

Hospital & facility affiliations 1

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1104922244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MONTAUK HWY",
            "address_2": "PO BOX 9182",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068403",
            "telephone_number": "631-758-4444",
            "fax_number": "631-758-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MEDFORD AVE",
            "address_2": "ROUTE 112",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721281",
            "telephone_number": "631-758-4444",
            "fax_number": "631-758-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE-SCELSA",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.