Lisa L Ellis, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA054156 Issued in PA

Practice address

102 Technology Dr
Suite 230
Butler, PA 16001-1784

Phone

(877) 661-3376

NPI assigned

Mar 12, 2010

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

Other identifiers 1

Other names 1

• Lisa L Henderson Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Butler Medical ProvidersGroup PAC ID 7416840160, shared by 2 NPIs, 355 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Independence Health System Butler Memorial Hospita Hospital, Butler, PA, CCN 390168

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Butler Medical Providers

  • Surgery Physician
  • Butler, PA
  • NPI 1982939567
  NPD
• Butler Medical Providers

  • Anatomic Pathology & Clinical Pathology Physician
  • Butler, PA
  • NPI 1447283031
  NPD (past)
• Butler Medical Providers

  • Dermatology Physician
  • New Castle, PA
  • NPI 1548683881
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Butler Healthcare Providers

  • General Acute Care Hospital
  • Butler, PA
  • NPI 1447317896
  Care Compare affiliation
• Butler Healthcare Providers

  • Ambulatory Surgical Clinic/Center
  • Butler, PA
  • NPI 1558428573

  Hospital

  Care Compare affiliation
• Butler Memorial Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Butler, PA
  • NPI 1821162314
  Care Compare affiliation

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1306169792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 TECHNOLOGY DRIVE",
            "address_2": "SUITE 230",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "16001",
            "telephone_number": "877-661-3376",
            "fax_number": "724-482-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 TECHNOLOGY DR",
            "address_2": "SUITE 230",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011784",
            "telephone_number": "877-661-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "MA054156",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HENDERSON",
            "middle_name": "L",
            "credential": "MPAS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Butler, PA
• Providers in Butler, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.