Lisa Kathryn Waynick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006673 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone

(313) 916-5000

NPI assigned

Jun 17, 2013

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 names 1

• Lisa Kathryn Reile Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwaynick594840@direct.hfhs.org

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.

• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1124467816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 HELENE AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673980",
            "telephone_number": "248-770-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_2": "William Beaumont Hospital",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAYNICK",
        "first_name": "LISA",
        "middle_name": "KATHRYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwaynic1@hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "REILE",
            "middle_name": "KATHRYN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wayne State University School of Medicine
• Wayne State University School of Medicine
• Wayne State University Speech and Language Center
• Wayne State University/Detroit Medical Center
• Melanie Yvonne Wayne
• Wce, LLC
• Wce, LLC
• We Are Family Covid Staffing LLC
• We Are Family Medical LLC
• We Can Help Home Chore Services

• Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.