Lisa Janelle Grant, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2234 Issued in MA

Practice address

55 Fogg Rd
South Shore Hospital Emergency Department
South Weymouth, MA 02190-2432

Phone

(781) 340-3627

NPI assigned

Oct 20, 2006

Last updated

Jun 1, 2011By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  NPD

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1285717736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 HERITAGE HL",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266206",
            "telephone_number": "617-999-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "address_2": "SOUTH SHORE HOSPITAL EMERGENCY DEPARTMENT",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-340-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "LISA",
        "middle_name": "JANELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "2234",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "2234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C LICENSE",
            "identifier": "1074133",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriela Gonzales Castillo, PT, DPT
• Robin Michelle Goodliss, O.T.R./L
• Robert L Gore, MD
• Jatinderpal Gosal, MD
• Cameron William Graaskamp
• Peter A. Grape, MD
• Jennifer Gray
• Hadley Meenan Groman, LICSW
• E James Gruver III, MD
• Marguerite Marie Guillaume, NP

• Physician Assistant in South Weymouth, MA
• Providers in South Weymouth, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.