Lisa Ianneillo Rubino, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP04844 Issued in LA

Practice address

1717 Oak Park Blvd FL 3
Lake Charles, LA 70601-8990

Phone

(337) 494-4720

Fax

(337) 494-2085

NPI assigned

Oct 25, 2017

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 Marie Ianneillo Former name

Medicare fee-for-service enrollment

Enrolled in LA

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

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

LCMS Neurosurgical Institute of Lake Charles LLCGroup PAC ID 8224189758, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lrubino5281994@direct.casso.us.com

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.

• LCMS Neurosurgical Institute of Lake Charles LLC

  • Multi-Specialty Clinic/Center
  • Lake Charles, LA
  • NPI 1851526917
  Medicare reassignment Care Compare group NPD
• Lake Charles Medical Services

  • Neurological Surgery Physician
  • Lake Charles, LA
  • NPI 1558305862
  NPD (past)

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

• Southwest Louisiana Hospital Association Inc

  • Gastroenterology Physician
  • Lake Charles, LA
  • NPI 1285351411

  Hospital

  Care Compare affiliation
• Southwest Louisiana Hospital Association Inc

  • Rheumatology Physician
  • Lake Charles, LA
  • NPI 1659424075

  Hospital

  Care Compare affiliation
• Southwest Louisiana Hospital Association Inc

  • General Acute Care Hospital
  • Lake Charles, LA
  • NPI 1972549855
  Care Compare affiliation

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1154833523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122425 DEPT 2425",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122425",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD FL 3",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018990",
            "telephone_number": "337-494-4720",
            "fax_number": "337-494-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "LISA",
        "middle_name": "IANNEILLO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP04844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "IANNEILLO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeremy Durand Royer, LPC
• Alexander Rozas, LAT
• Brooke Rozas, APRN
• Elizabeth Rubino
• Gregory J Rubino, MD
• Justin William Rudd, M.D.
• Sydney Dianna Rudy, DPM
• Robert L Rumsey, MD
• Rural Healthcare Developers of Louisiana LLC
• Rural Healthcare Developers of Louisiana LLC

• Family Nurse Practitioner in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.