Maria Lissette Pacheco, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

789 Issued in TN

Practice address

1039 Executive Dr Ste 102
Hixson, TN 37343-7900

Phone

(423) 541-7000

NPI assigned

Mar 25, 2013

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DHGECD/Endpoint/DHGECD

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.

• Chattanooga Foot & Ankle PLLC

  • Podiatrist
  • Hixson, TN
  • NPI 1588248843
  Medicare reassignment NPD Authorized official

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

• Memorial Health Care System Inc.

  • General Acute Care Hospital
  • Hixson, TN
  • NPI 1083778633
  Care Compare affiliation
• Memorial Health Care System Inc.

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736
  Care Compare affiliation

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1336481589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 EXECUTIVE DR STE 102",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 EXECUTIVE DR STE 102",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437900",
            "telephone_number": "423-541-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MARIA",
        "middle_name": "LISSETTE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q066173",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orange Grove Center, Inc
• Orange Grove Center, Inc
• Orange Grove Center, Inc
• Kelly M Ovante
• Dan Eugene Owen, O.D.
• Carolyn Blair Padalino, DPT
• Pamela H. Johnson, LCSW, PC
• Katelin McCall Pannell, MD
• Breanne Parker, PHARMD
• Christina Rebecca Parkhurst, MEDICAL DOCTOR

• Podiatrist in Hixson, TN
• Providers in Hixson, TN by specialty
• Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2021; 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.