NPIMap

Individual provider Active NPI

Lisa Brazil, C.F.N.P.

  • Family Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1154419117
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R34090 Issued in NM
Practice address
35 Casa St Ste 320
San Luis Obispo, CA 93405
Phone
(805) 250-4844
Fax
(057) 850-3568
NPI assigned
Oct 11, 2006
Last updated
Jan 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R34090 NM Primary

Addresses

Primary practice location

35 Casa St Ste 320
San Luis Obispo, CA 93405

Mailing address

35 Casa St Ste 320
San Luis Obispo, CA 93405-1894
Phone (805) 250-4844

Other practice location 1

105 Mills Ave Ste 200
Las Vegas, NM 87701-4169
Phone (505) 454-1109

Other practice location 2

105 Mills Ave Ste 200
Las Vegas, NM 87701-4169
Phone (505) 454-1109

Other identifiers 1

IdentifierTypeStateIssuer
53704533MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190415002085 CA Practitioner - Nurse Practitioner 7618930629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
David B. HammerGroup PAC ID 3971559881, 117 clinicians

Practice addresses (Care Compare)

1051 Las Tablas Rd
Templeton, CA 93465-5603

1154 E Grand Ave
Arroyo Grande, CA 93420-2583
Phone (805) 395-3277

959 Las Tablas Rd
Suite B3
Templeton, CA 93465-9703
Phone (805) 395-3277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
64.37
Promoting interoperability
100
Improvement activities
40
Cost
72.88

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R34090NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners CurrentSince Feb 1, 2019 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
First Choice Physician Partners Current Accepting new patients
Adventist Health Physicians Network CurrentSince Mar 29, 2024 Accepting new patients
First Choice Physician Partners CurrentSince Feb 1, 2019 Accepting new patients
Adventist Health Physicians Network CurrentSince Mar 29, 2024 Accepting new patients
New Mexico Quickcare LLC Family Medicine Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Corazon Family Health PC Family Medicine PastSince Apr 1, 2013 Accepting new patients
Truecare LLC Family Medicine PastSince Jan 1, 2016 Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients
Santa Fe Medical Group, LLC Past Accepting new patients
Dignity Community Care Past Accepting new patients
Okaloosa Hospital Inc Past Accepting new patients

Locations

1154 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 395-3277

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

35 Casa St
Ste 320
San Luis Obispo, CA 93405
Phone (805) 250-4844

1220 Las Tablas Rd
#1418
Templeton, CA 93465
Phone (805) 434-1825

Interoperability endpoints

  • Direct secure messaging: lisa.brazil.1@31068.direct.athenahealth.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1154419117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CASA ST STE 320",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051894",
            "telephone_number": "805-250-4844",
            "fax_number": "057-850-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CASA ST STE 320",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-250-4844",
            "fax_number": "057-850-3568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Mills Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877014169",
            "country_code": "US",
            "telephone_number": "505-454-1109",
            "fax_number": "505-454-1779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Mills Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877014169",
            "country_code": "US",
            "telephone_number": "505-454-1109",
            "fax_number": "505-454-1779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZIL",
        "first_name": "LISA",
        "credential": "C.F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "R34090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53704533",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.