Individual provider Active NPI

Lisa D Romero, FNP-C

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1255575411
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP3306 Issued in AZ
Practice address
1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone
(480) 610-7100
Fax
(480) 610-7115
NPI assigned
Apr 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP3306 AZ Primary

Addresses

Primary practice location

1917 S Crismon Rd
Mesa, AZ 85209-6216

Mailing address

1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone (480) 610-7100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090826000450 AZ Practitioner - Nurse Practitioner 3971658048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

1917 S Crismon Rd
Mesa, AZ 85209-6216
Phone (480) 610-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3306AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Sep 23, 2024 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

1917 S Crismon Rd
Mesa, AZ 85209
Phone (480) 610-7100

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

Interoperability endpoints

  • Direct secure messaging: ms_lromer59@landmarkhealth-direct.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1255575411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096216",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096216",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "LISA",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.