Individual provider Active NPI

Ashley Lisiewski, DO

  • Emergency Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1154764611
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
UO2828 Issued in FL
Practice address
7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone
(954) 883-8855
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X UO2828 FL Primary

Addresses

Primary practice location

7800 Sheridan St
Pembroke Pines, FL 33024-2536

Mailing address

3810 NE 167TH St
North Miami Beach, FL 33160-3539

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alisiewski121697@mhsdirect.net

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
I20150817002184 FL Practitioner - Emergency Medicine 7618282872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inphynet South Broward LLCGroup PAC ID 4587563960, 67 clinicians

Practice addresses (Care Compare)

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (954) 962-9650

Hospital & facility affiliations

  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO2828FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet South Broward LLC Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

7800 Sheridan St
Pembroke Pines, FL 33024
Phone (954) 962-9650

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

Interoperability endpoints

  • Direct secure messaging: alisiewski121697@mhsdirect.net

Organizations & group practices 1

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1154764611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 NE 167TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331603539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SHERIDAN ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330242536",
            "telephone_number": "954-883-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISIEWSKI",
        "first_name": "ASHLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "UO2828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alisiewski121697@mhsdirect.net",
            "affiliation": "N",
            "address_1": "7800 Sheridan St",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330242536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.