Lisa Marie Maccormack, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

36900 Issued in CO

Practice address

4231 W 16TH Ave
Denver, CO 80204-1335

Phone

(303) 629-3721

Fax

(303) 629-2192

NPI assigned

May 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Pacific Redwood Medical Group Inc

  • Emergency Medicine Physician
  • Ukiah, CA
  • NPI 1033103676
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1245289834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 W MINERAL AVE",
            "address_2": "SUITE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205685",
            "telephone_number": "303-759-0854",
            "fax_number": "303-759-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 W 16TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802041335",
            "telephone_number": "303-629-3721",
            "fax_number": "303-629-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCORMACK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A68040",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "36900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A680400",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00808581",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32851871",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mac Informatics
• Francis Ryan Ante Macalalag, PHARMD.
• Susan J Macaskill, PA
• Shannon Lea Maccabe
• Michelle Maccarthy, DC
• Christine Mary Maccune
• Ashly Macdonald
• Ellen Macdonald, DDS
• Gary Macdonald, PH.D.
• Kimberly Jane Macdonald

• Emergency Medicine Physician in Denver, CO
• Providers in Denver, CO by specialty
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.