Individual provider Active NPI

Lisa Craigs Medel, D.C.

  • Chiropractor
  • Bonney Lake, WA
National Provider Identifier
1265526628
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60464407 Issued in WA
Practice address
19102 Sr 410 E
Bonney Lake, WA 98391-8449
Phone
(253) 863-6378
NPI assigned
Oct 2, 2006
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-30327 CA
Chiropractor 111N00000X CH60464407 WA Primary

Addresses

Primary practice location

19102 Sr 410 E
Bonney Lake, WA 98391-8449

Mailing address

9812 205TH Ave E Ste C
Bonney Lake, WA 98391-8275
Phone (253) 863-6378

Other practice location 1

703 Market St
Suite 1214
San Francisco, CA 94103-2102
Phone (415) 546-1461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114000359 WA Practitioner - Chiropractic 9032544473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Chirorpactic PLLCGroup PAC ID 9537174123, 6 clinicians

Practice addresses (Care Compare)

9812 205TH Ave E
Suite C
Bonney Lake, WA 98391-8382
Phone (253) 863-6378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-30327CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Chirorpactic PLLC Chiropractor CurrentSince Nov 3, 2019 Accepting new patients
Mazgaloff Chiropractic, Inc Chiropractor Past Accepting new patients

Locations

19102 State Route 410 E
Ste A
Bonney Lake, WA 98391
Phone (253) 651-9399

9812 205th Ave E
Ste C
Bonney Lake, WA 98391
Phone (253) 863-6378

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1265526628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9812 205TH AVE E STE C",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918275",
            "telephone_number": "253-863-6378",
            "fax_number": "253-863-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19102 SR 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918449",
            "telephone_number": "253-863-6378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Market St",
            "address_2": "Suite 1214",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032102",
            "country_code": "US",
            "telephone_number": "415-546-1461",
            "fax_number": "416-546-3136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDEL",
        "first_name": "LISA",
        "middle_name": "CRAIGS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-30327",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60464407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.