Individual provider Active NPI

Lisha Hasskamp, PA

  • Physician Assistant
  • Dededo, GU
National Provider Identifier
1336879527
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1088 W Marine Corps Dr Ste 239
Dededo, GU 96929-5553
Phone
(671) 637-2873
NPI assigned
Jun 12, 2022
Last updated
Jun 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1088 W Marine Corps Dr Ste 239
Dededo, GU 96929-5553

Mailing address

126 E Daog CT
Dededo, GU 96929-5527
Phone (671) 787-5252

Other practice location 1

302 S Route 4 Ste 207
Chalan Pago, GU 96910
Phone (671) 477-2873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Expresscare Health and Skin Center Past Accepting new patients
Expresscare Health and Skin Center Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1336879527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E DAOG CT",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969295527",
            "telephone_number": "671-787-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W MARINE CORPS DR STE 239",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969295553",
            "telephone_number": "671-637-2873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 S Route 4 Ste 207",
            "address_purpose": "LOCATION",
            "city": "Chalan Pago",
            "state": "GU",
            "postal_code": "96910",
            "country_code": "US",
            "telephone_number": "671-477-2873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSKAMP",
        "first_name": "LISHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dededo, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.