Lisa J Trickey, PA C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0050661 Issued in NY

Practice address

1340 Washington St
Watertown, NY 13601-4541

Phone

(315) 782-9003

Fax

(315) 782-9010

NPI assigned

Aug 15, 2005

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

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

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Hospital IncGroup PAC ID 2567372899, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Home Health, Inc Home health agency, Watertown, NY, CCN 337254
• Jefferson Co Pub HLTH SVS Chha Home health agency, Watertown, NY, CCN 337056
• River Hospital Clinics Hospital, Alexandria Bay, NY, CCN 331309
• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• River Hospital, Inc.

  • Critical Access Hospital
  • Alexandria Bay, NY
  • NPI 1003814641

  NY

  Medicare reassignment Care Compare group
• River Hospital, Inc.

  • Rural Health Clinic/Center
  • Alexandria Bay, NY
  • NPI 1831452994

  Medical

  Care Compare group NPD
• River Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Alexandria Bay, NY
  • NPI 1821022781
  Care Compare group

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

• Jefferson County Public Health Service

  • Home Health Agency
  • Watertown, NY
  • NPI 1043213283
  Care Compare affiliation
• River Hospital, Inc.

  • Critical Access Hospital
  • Alexandria Bay, NY
  • NPI 1003814641

  Hospital

  Care Compare affiliation
• River Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Alexandria Bay, NY
  • NPI 1821022781

  Hospital

  Care Compare affiliation
• Samaritan Home Health Inc

  • Home Health Agency
  • Watertown, NY
  • NPI 1487057576
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225030752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQUARE",
            "address_2": "INTERNAL MEDICINE OF NORTHERN NEW YORK SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-782-4950",
            "fax_number": "315-782-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014541",
            "telephone_number": "315-782-9003",
            "fax_number": "315-782-9010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53-59 Public Square",
            "address_2": "Internal Medicine of Northern New York Suite 201",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136012674",
            "country_code": "US",
            "telephone_number": "315-782-4950",
            "fax_number": "315-782-3699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRICKEY",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0050661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Watertown, NY
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.