Individual provider Active NPI

Lisa M Hoffman, FNP-C

  • Family Nurse Practitioner
  • Petoskey, MI
National Provider Identifier
1164449765
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704206725 Issued in MI
Practice address
2325 Summit Park Dr
Suite 3
Petoskey, MI 49770-8774
Phone
(231) 439-5100
Fax
(231) 439-9292
NPI assigned
Jul 17, 2006
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704206725 MI Primary

Addresses

Primary practice location

2325 Summit Park Dr
Suite 3
Petoskey, MI 49770-8774

Mailing address

2325 Summit Park Dr
Suite 3
Petoskey, MI 49770-8774
Phone (231) 439-5100

Other names 1

  • Ms. Lisa M Vigneau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20040608000098 MI Practitioner - Nurse Practitioner 3173506607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bayside Family and Sports Medicine PCGroup PAC ID 6608881867, 4 clinicians

Practice addresses (Care Compare)

2325 Summit Park Dr
Suite 3
Petoskey, MI 49770-8774
Phone (231) 439-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704206725MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Family & Sports Medicine PC CurrentSince Feb 16, 2018 Accepting new patients
Community Memorial Hospital Past Accepting new patients

Locations

2325 Summit Park Dr
Ste 3
Petoskey, MI 49770
Phone (231) 439-5100

Interoperability endpoints

  • Direct secure messaging: lisahoffman@bfsm.allscriptsdirect.net

Organizations & group practices 2

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 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1164449765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 SUMMIT PARK DR",
            "address_2": "SUITE 3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708774",
            "telephone_number": "231-439-5100",
            "fax_number": "231-439-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 SUMMIT PARK DR",
            "address_2": "SUITE 3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708774",
            "telephone_number": "231-439-5100",
            "fax_number": "231-439-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704206725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "VIGNEAU",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.