NPIMap

Individual provider Active NPI

Morgan Mellisande Lisner, M.D.

  • Family Medicine Physician
  • Hillsboro, OR
National Provider Identifier
1134412794
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD196628 Issued in OR
Practice address
6355 NE Cornell Rd Ste 100
Hillsboro, OR 97124-5434
Phone
(503) 597-3130
Fax
(503) 597-3140
NPI assigned
May 16, 2011
Last updated
Feb 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD196628 OR Primary
Family Medicine Physician 207Q00000X 52984 TN

Addresses

Primary practice location

6355 NE Cornell Rd Ste 100
Hillsboro, OR 97124-5434

Mailing address

6355 NE Cornell Rd Ste 100
Hillsboro, OR 97124-5434
Phone (503) 597-3130

Other practice location 1

1301 Primacy Pkwy
Memphis, TN 38119-0213
Phone (901) 866-8812

Other identifiers 6

IdentifierTypeStateIssuer
184972MedicaidAL
Q019173MedicaidTN
05624779MedicaidMS
1134412794MedicaidMO
212922001MedicaidAR
003181727AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200130001718 OR Practitioner - Family Practice 6002131323 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52984TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Feb 3, 2020 Accepting new patients
Tuality Medical Group LLC CurrentSince Feb 7, 2020 Accepting new patients
University Professional Services CurrentSince Feb 3, 2020 Accepting new patients
Tuality Healthcare Current Accepting new patients
University Professional Services Current Accepting new patients
Oregon Health & Science University CurrentSince Feb 3, 2020 Accepting new patients
Oregon Health & Science University CurrentSince Feb 3, 2020 Accepting new patients
Tuality Medical Group LLC CurrentSince Feb 7, 2020 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

349 SE 7th Ave
Hillsboro, OR 97123
Phone (503) 648-0803

6355 NE Cornell Rd
Ste 100
Hillsboro, OR 97124
Phone (503) 597-3130

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

4212 SE Division St
Ste 150
Portland, OR 97206
Phone (503) 418-1500

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

Interoperability endpoints

  • Direct secure messaging: mlisner120664@direct.ohsu.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1134412794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 NE CORNELL RD STE 100",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245434",
            "telephone_number": "503-597-3130",
            "fax_number": "503-597-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 NE CORNELL RD STE 100",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245434",
            "telephone_number": "503-597-3130",
            "fax_number": "503-597-3140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Primacy Pkwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381190213",
            "country_code": "US",
            "telephone_number": "901-866-8812",
            "fax_number": "901-302-2812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISNER",
        "first_name": "MORGAN",
        "middle_name": "MELLISANDE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD196628",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "52984",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184972",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019173",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05624779",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134412794",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212922001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181727A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.