Lisa Marie Ambrogio-Decola, PA
Individual provider Active NPI Surgical Physician Assistant · Meriden, CT
NPI 1295741825 · NPPES record last updated Jun 26, 2019
Key facts
- NPI
- 1295741825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 001246 (CT)
- Practice address
- 435 Lewis Ave Ste 103
Meriden, CT 06451-2101 - Phone
- (203) 694-7550
- Fax
- (203) 694-7555
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hartford Healthcare Medical Group Specialists PLLC
Practice addresses (Care Compare)
1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579
435 Lewis Ave
Meriden, CT 06451-2101
Hospital & facility affiliations
- Midstate Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031218000210 | CT | Practitioner - Physician Assistant | 2264339175 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001246 | CT | MD | Addiction (Substance Use Disorder) Counselor |
| 1246 | CT | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists LLC | Current |
Accepting new patients | |
| Hartford Healthcare Medical Group, Inc | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients | |
| Hartford Healthcare Medical Group Specialists, PLLC | Surgical | Current |
Accepting new patients |
| Northeast Medical Group Inc | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients | |
| Northeast Medical Group, Inc. | Current |
Accepting new patients | |
| Connecticut Orthopaedic Specialists, PC | Current | Accepting new patients | |
| Connecticut Orthopaedic Specialists, PC | Surgical | Past | Accepting new patients |
| Connecticut Orthopaedic Specialists, PC | Surgical | Past | Accepting new patients |
| Saint Mary'S Hospital Inc. | Past |
Accepting new patients |
Locations
84 N Main St
Bldg 2
Branford, CT 06405
Phone (203) 407-1500
2408 Whitney Ave
Hamden, CT 06518
Phone (203) 407-3500
435 Lewis Ave
Ste 103
Meriden, CT 06451
Phone (203) 694-7550
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151
190 Universal Dr N
North Haven, CT 06473
Phone (203) 234-1891
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
1 Bradley Rd
Ste 501502
Woodbridge, CT 06525
Phone (203) 389-2278
1 Bradley Rd
#501502
Woodbridge, CT 06525
Interoperability endpoints
- lisa.ambrogio@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 001246 | CT | Yes |
Addresses
Primary practice location
435 Lewis Ave Ste 103
Meriden, CT 06451-2101
Mailing address
435 Lewis Ave
Ste 103
Meriden, CT 06451-2101
Phone (203) 789-3997
Other practice location 1
1450 Chapel St
New Haven, CT 06511-4405
Phone (203) 789-3997
Other providers in Meriden, CT
- Jonathan Craig Allen
- Richard S Allen
- Susan Alsamarai
- Cristobal G Alvarado
- Melissa Alvarez
- Denny R Amparo
- Collins I. Anaeche
- Elizabeth Anders
- Sarah Phillips Anderson
- Jason D. Andrus
All providers in Meriden, CT · Surgical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.