Lisa A Oberg, N.P.P.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

401070 Issued in NY

Practice address

11 Century Hill Drive
Suite 206
Latham, NY 12110-2151

Phone

(518) 713-4595

Fax

(518) 713-4598

NPI assigned

Jul 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oberg Psychiatric Nurse Practitioner, PLLC

  • Local Education Agency (LEA)
  • Clifton Park, NY
  • NPI 1558812297
  Medicare reassignment Authorized official
• Psychopharmacology Consultants of Albany, PLLC

  • Psychiatry Physician
  • Colonie, NY
  • NPI 1114050390
  NPD (past)

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1174723779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CENTURY HILL DRIVE",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102151",
            "telephone_number": "518-713-4595",
            "fax_number": "518-713-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CENTURY HILL DRIVE",
            "address_2": "SUITE 206",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102151",
            "telephone_number": "518-713-4595",
            "fax_number": "518-713-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERG",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "N.P.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen O'Donnell-Nichols, RPH
• Emily Rose O'Donnell, FNP-BC
• Aimee O'Keefe, LCSW
• Elisabeth O'Rourke
• Jacqueline A O'Shea, P.A.
• Theresa Ochei
• Abigail Catherine Oconnor
• Yumeno Nagata Oliver, LMSW
• Ana Orellano, M.S.ED
• Orthopedicsny, LLP

• Psychiatric/Mental Health Nurse Practitioner in Latham, NY
• Providers in Latham, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.