Active NPI
Lisa Matisko, DMD, MDS
- Endodontics
- Pittsburgh, PA
National Provider Identifier
1184786626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DS027342L
- Practice address
- 1789 S Braddock Ave
Suite 110
Pittsburgh, PA 15218-1842 - Phone
- (412) 242-4022
- Fax
- (412) 242-4606
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DS027342L | PA | Primary |
Addresses
Primary practice location
1789 S Braddock Ave
Suite 110
Pittsburgh, PA 15218-1842
Mailing address
1789 S Braddock Ave
Suite 110
Pittsburgh, PA 15218-1842
Phone (412) 242-4022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS027342L | PA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edgewood Dental Associates | Past | Accepting new patients |
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.
-
- Dentist
- Pittsburgh, PA
- NPI 1548354004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184786626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1789 S BRADDOCK AVE",
"address_2": "SUITE 110",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152181842",
"telephone_number": "412-242-4022",
"fax_number": "412-242-4606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1789 S BRADDOCK AVE",
"address_2": "SUITE 110",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152181842",
"telephone_number": "412-242-4022",
"fax_number": "412-242-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATISKO",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "DMD, MDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS027342L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.