Ellisiv Lien, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

N1735 Issued in TX

Practice address

2737 S Broadway Ave
Tyler, TX 75701-5413

Phone

(903) 592-6000

Fax

(903) 592-3224

NPI assigned

Jan 22, 2009

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charles R Gordon MD PAGroup PAC ID 8729992052, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ellisiv.lien.p1@direct.precisionspinecare.nextgenshare.com

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.

• Charles R Gordon MD PA

  • Neurological Surgery Physician
  • Tyler, TX
  • NPI 1982717955
  Medicare reassignment Care Compare group NPD
• Charles R Gordon MD PA

  • Interventional Pain Medicine Physician
  • Lufkin, TX
  • NPI 1720513328
  NPD

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1265670749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6605",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116605",
            "telephone_number": "903-592-6000",
            "fax_number": "903-592-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015413",
            "telephone_number": "903-592-6000",
            "fax_number": "903-592-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEN",
        "first_name": "ELLISIV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "N1735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty County Hospital District No. 1
• Jamie Librizzi, M.D.
• Jalicsa Gemahi Licerio, LVN
• Nancy S. Lieb, M.D.
• Scott M Lieberman, MD
• Lifeguard Family Health L.L.C.
• Lifeline Therapy Services
• Lifetime Health Center
• Krystal Gayle Lilley, LVN
• Paul J. Lim, M.D.

• Physical Medicine & Rehabilitation Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.