Individual provider Active NPI

Lisa Akiye Yamamoto, D.O.

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1134440035
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS19473 Issued in FL
Practice address
1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564
Phone
(772) 398-1800
Fax
(772) 398-1825
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS19473 FL Primary
Family Medicine Physician 207Q00000X 006739 AZ
Family Medicine Physician 207Q00000X 91303 MT
Hospitalist Physician 208M00000X 006739 AZ

Addresses

Primary practice location

1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564

Mailing address

3496 NW Federal Hwy
Jensen Beach, FL 34957-4441

Other practice location 1

3496 NW Federal Hwy
Jensen Beach, FL 34957-4441
Phone (619) 347-2193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160714002427 AZ Practitioner - Family Practice 3577855352 Reassigns benefits to 1 organization
I20230213000778 FL Practitioner - Family Practice 3577855352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland Clinic FloridaGroup PAC ID 7911807128, 717 clinicians

Practice addresses (Care Compare)

2950 Cleveland Clinic Blvd
Weston, FL 33331-3609
Phone (954) 659-5000

Hospital & facility affiliations

  • Cleveland Clinic Hospital Hospital, Weston, FL, CCN 100289

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.26
Promoting interoperability
100
Improvement activities
40
Cost
78.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91303MTMDFamily Medicine Physician
006739AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Mar 5, 2025 Accepting new patients
North Brevard Medical Support, Inc CurrentSince Nov 18, 2022 Accepting new patients
Kingman Healthcare, Inc CurrentSince Aug 8, 2016 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Aug 8, 2016 Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

390 Challenger Rd
Port Canaveral, FL 32920
Phone (321) 633-8640

3801 S Kanner Hwy
Ste 100
Stuart, FL 34994
Phone (772) 419-3900

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

3801 S Kanner Hwy
Ste 300
Stuart, FL 34994
Phone (772) 223-4978

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

805 Century Medical Dr
Ste C
Titusville, FL 32796
Phone (321) 268-6264

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

1825 N Corporate Lakes Blvd
Weston, FL 33326
Phone (954) 349-1111

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1134440035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3496 NW FEDERAL HWY",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349574441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-398-1800",
            "fax_number": "772-398-1825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3496 NW Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Jensen Beach",
            "state": "FL",
            "postal_code": "349574441",
            "country_code": "US",
            "telephone_number": "619-347-2193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "LISA",
        "middle_name": "AKIYE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2024-07-29",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19473",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "006739",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "91303",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "006739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.