Lisa Ann Rose Wadsworth, MMS. PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2929 Issued in AZ

Practice address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Phone

(480) 301-8000

NPI assigned

Apr 28, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25544/brand/1/csg/1/fhir/r4
• Direct secure messaging: lisa.wadsworth.1@25544.direct.athenahealth.com

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.

• Neurology Consultants of Arizona, LLC

  • Neurology Physician
  • Scottsdale, AZ
  • NPI 1184182370
  NPD (past)

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1114192317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "LISA",
        "middle_name": "ANN ROSE",
        "name_prefix": "Ms.",
        "credential": "MMS. PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370217",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John M. Wachtel, DMD
• Tarianne Marie Wachtel, D.M.D.
• Jordan Russell Wachter
• Erica Melissa Wade, MS
• Sabrina Nicole Wade, OTR/L
• Kimberly N Waerness, R.PH
• Cara Suzanne Wagen
• Joshua D. Waggoner, M.D.
• Sheldon Paul Wagman, D.O.
• Barrie Rachele Wagner, PSY. D.

• Physician Assistant in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.