Jeffrey R Lisse, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

28777 Issued in AZ

Practice address

535 N. Wilmot
#101
Tucson, AZ 85711

Phone

(520) 874-7400

Fax

(520) 874-3425

NPI assigned

Jun 23, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• DHHS PHS Naihs Fort Defiance Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1316973217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857067124",
            "telephone_number": "520-874-7400",
            "fax_number": "520-874-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N. WILMOT",
            "address_2": "#101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85711",
            "telephone_number": "520-874-7400",
            "fax_number": "520-874-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSE",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AZ",
            "license": "28777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "536675",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa S Magee
• Stefanie Lischer Liers, LAC
• Kelly Liska
• Christina Marie Lisowski, MA CCCSLP
• Marilyn S Liss, RN
• Cristina Marie Lister, FNP
• Sharon Evette Lister, DDS
• James G Liston, OD
• Phoebe Lithgow, CNM, WHNP-BC
• Ben Litmanovich

• Rheumatology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Rheumatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.