Lori Macisaac, R PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0084671 Issued in NY

Practice address

6734 Route 9
Rhinebeck, NY 12572-3724

Phone

(845) 231-5600

Fax

(845) 202-6713

NPI assigned

Apr 19, 2006

Last updated

Nov 18, 2016By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Physician Assistant

Education

Mercy College, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
• Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: lmacisaac143083@direct.optum.com

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.

• Optum Medical Care, P.C.

  dba CareMount Medical, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment Care Compare group
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Hudson Valley Emergency Medicine PLLC

  • General Practice Physician
  • Poughkeepsie, NY
  • NPI 1093746505
  NPD (past)
• Mount Kisco Medical Group

  • Hematology (Internal Medicine) Physician
  • Fishkill, NY
  • NPI 1952356362
  NPD (past)

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

• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599
  Care Compare affiliation
• Northern Dutchess Hospital

  • General Acute Care Hospital
  • Rhinebeck, NY
  • NPI 1124072715
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1174588495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "address_2": "CAREMOUNT MEDICAL PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-241-1050",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6734 ROUTE 9",
            "city": "RHINEBECK",
            "state": "NY",
            "postal_code": "125723724",
            "telephone_number": "845-231-5600",
            "fax_number": "845-202-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACISAAC",
        "first_name": "LORI",
        "credential": "R PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0084671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Maryann Luparello-Ragusa, FNP
• Carrie Brooke Lutzke, D.P.T.
• Candace M Lynch, MSW
• Elizabeth Sadie Lynch
• Russell Macek, RN
• Michael Christopher Madigan, O.D.
• Susan Lynn Maher, R.PH.
• Jack M Mancus, M.D.
• Anna Manente
• Tammy L Manicone, PTA

• Physician Assistant in Rhinebeck, NY
• Providers in Rhinebeck, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.