Individual provider Active NPI

Lisa Marie Evans, NP

  • Acute Care Nurse Practitioner
  • Orange, CA
National Provider Identifier
1346561057
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP19437 Issued in CA
Practice address
1010 W la Veta Ave Ste 750
Orange, CA 92868-4312
Phone
(714) 361-6600
Fax
(714) 919-8804
NPI assigned
Jun 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP19437 CA Primary

Addresses

Primary practice location

1010 W la Veta Ave Ste 750
Orange, CA 92868-4312

Mailing address

1010 W la Veta Ave Ste 750
Orange, CA 92868-4312
Phone (714) 361-6600

Other identifiers 4

IdentifierTypeStateIssuer
CG5665OtherCARAILROAD MEDICARE GROUP PTAN
1912919804OtherCATYPE 2 NPI
P01438733OtherCARAILROAD MEDICARE PROVIDER PTAN
1912919804MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20100915000511 CA Practitioner - Nurse Practitioner 7416072368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Critical Care and Pulmonary Specialists IncGroup PAC ID 7113289539, 10 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 771-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19437CAMDMental Health Counselor
NP19437CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Trauma Inc CurrentSince Aug 22, 2017 Accepting new patients

Locations

27799 Medical Center Rd
Ste 440
Mission Viejo, CA 92691
Phone (949) 364-1007

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346561057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 750",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684312",
            "telephone_number": "714-361-6600",
            "fax_number": "714-919-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 750",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684312",
            "telephone_number": "714-361-6600",
            "fax_number": "714-919-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP19437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "CG5665",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 NPI",
            "identifier": "1912919804",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER PTAN",
            "identifier": "P01438733",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912919804",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.