Individual provider Active NPI

Lisa Fernandes, OT

  • Occupational Therapist
  • Exeter, NH
National Provider Identifier
1265769061
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1729 Issued in NH
Practice address
1 Hampton Rd
Suite 200
Exeter, NH 03833-4855
Phone
(603) 775-7575
Fax
(603) 778-9680
NPI assigned
Nov 16, 2009
Last updated
Feb 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1729 NH Primary

Addresses

Primary practice location

1 Hampton Rd
Suite 200
Exeter, NH 03833-4855

Mailing address

1 Hampton Rd
Suite 200
Exeter, NH 03833-4855
Phone (603) 775-7575

Other identifiers 2

IdentifierTypeStateIssuer
3102183MedicaidNH
NH4111OtherNHMEDICARE GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100126000455 NH Practitioner - Occupational Therapist in Private Practice 2062554207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Procare Physical Therapy and Hand CenterGroup PAC ID 5890797096, 9 clinicians

Practice addresses (Care Compare)

1900 Lafayette Rd
Portsmouth, NH 03801-5679
Phone (603) 431-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Physical Therapy and Hand Center Occupational Therapist CurrentSince Sep 8, 2020 Accepting new patients

Locations

1900 Lafayette Rd
Ste C
Portsmouth, NH 03801
Phone (603) 431-5600

Organizations & group practices 1

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1265769061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HAMPTON RD",
            "address_2": "SUITE 200",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334855",
            "telephone_number": "603-775-7575",
            "fax_number": "603-778-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAMPTON RD",
            "address_2": "SUITE 200",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334855",
            "telephone_number": "603-775-7575",
            "fax_number": "603-778-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "1729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102183",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "NH4111",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.