Lisa Marie Blasko, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TAP5705 Issued in AZ

Practice address

120 E Main St Ste B
Payson, AZ 85541-5618

Phone

(928) 472-2225

Fax

(928) 468-0002

NPI assigned

Jul 7, 2014

Last updated

Apr 29, 2026By 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 2

Addresses

Other names 1

• Lisa Marie Martin Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chelani Productions, LLCGroup PAC ID 0547784746, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Payson Medical Center Hospital, Payson, AZ, CCN 031318
• Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chelani Productions, LLC

  dba Gabbert Medical

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1417768110
  Medicare reassignment Care Compare group NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1619345675
  NPD
• Regenthetics, LLC

  • Pain Clinic/Center
  • Payson, AZ
  • NPI 1932717550
  NPD
• North Country Healthcare Inc

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1053587261
  NPD (past)

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

• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  Care Compare affiliation
• Bullhead City Hospital Corporation

  dba Western Arizona Regional Medical Center

  • General Acute Care Hospital
  • Bullhead City, AZ
  • NPI 1255302766
  Care Compare affiliation
• Bullhead City Hospital Corporation

  dba Fox Creek Urgent Care

  • Urgent Care Clinic/Center
  • Bullhead City, AZ
  • NPI 1780996223

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1245646629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E BROWN RD",
            "city": "STAR VALLEY",
            "state": "AZ",
            "postal_code": "855416561",
            "telephone_number": "928-472-2225",
            "fax_number": "928-468-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E MAIN ST STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415618",
            "telephone_number": "928-472-2225",
            "fax_number": "928-468-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASKO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP5705",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "AZ",
            "license": "RN152442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MARTIN",
            "middle_name": "MARIE",
            "credential": "DNP,FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy S Beier, SLP
• Charles M. Beier, D.D.S., P.C.
• BHSM Rehabilitation, LLC
• BHSM Rehabilitation, LLC (Banner Physical Therapy)
• William Raymond Blackmore, DDS
• Tyri Norman Blondal, LMSW
• Sheila Eva Bloomquist, MD
• Bonanza Square Dentistry LLC
• Cynthia D Booth, MD
• Steven Nicholas Booth, DDS

• Family Nurse Practitioner in Payson, AZ
• Providers in Payson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.