Individual provider Active NPI

Lisa Ross Dixon, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Gainesville, FL
National Provider Identifier
1124073176
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME90083 Issued in FL
Practice address
6400 W. Newberry Road
Suite 302
Gainesville, FL 32605
Phone
(352) 331-8902
Fax
(352) 224-1094
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME90083 FL Primary

Addresses

Primary practice location

6400 W. Newberry Road
Suite 302
Gainesville, FL 32605

Mailing address

6400 W. Newberry Road
Suite 302
Gainesville, FL 32605
Phone (352) 331-8902

Other identifiers 1

IdentifierTypeStateIssuer
269758100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000559 FL Practitioner - Pathology 6800871260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of South Carolina School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease AssociatesGroup PAC ID 2365425816, 27 clinicians

Practice addresses (Care Compare)

6400 W Newberry Rd
Suite 308
Gainesville, FL 32605-6604

6400 W Newberry Rd
Suite 308
Gainesville, FL 32605-6609
Phone (352) 331-8902

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Associates CurrentSince Oct 1, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2004 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2004 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

6400 W Newberry Rd
Ste 308
Gainesville, FL 32605
Phone (352) 331-8902

6400 W Newberry Rd
Ste 302
Gainesville, FL 32605
Phone (352) 331-8902

Interoperability endpoints

  • Direct secure messaging: lisadixon@dda.allscriptsdirect.net

Organizations & group practices 3

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1124073176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 W. NEWBERRY ROAD",
            "address_2": "SUITE 302",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-331-8902",
            "fax_number": "352-224-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W. NEWBERRY ROAD",
            "address_2": "SUITE 302",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-331-8902",
            "fax_number": "352-224-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "LISA",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME90083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269758100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.