Individual provider Active NPI

Eric Lis, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1366420713
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
199037 Issued in NY
Practice address
1275 York Ave
New York, NY 10021-6007
Phone
(212) 639-2000
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 199037 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10021-6007

Mailing address

633 3Rd Ave
Box 3
New York, NY 10017-6706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110127000897 NY Practitioner - Diagnostic Radiology 5698954238 Reassigns benefits to 1 organization
I20170627001208 NJ Practitioner - Diagnostic Radiology 5698954238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians
MSK BergenGroup PAC ID 1456614114, 254 clinicians
MSK MonmouthGroup PAC ID 1153619291, 300 clinicians

Practice addresses (Care Compare)

1101 Hempstead Tpke
Uniondale, NY 11553-1112
Phone (516) 559-1000

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

160 E 53Rd St
New York, NY 10022-5243
Phone (212) 610-0496

225 Summit Ave
Montvale, NJ 07645-1523
Phone (908) 542-3336

300 E 66TH St
New York, NY 10065-6800
Phone (646) 888-5300

480 Red Hill Rd
Middletown, NJ 07748-3052
Phone (908) 542-3007

650 Commack Rd
Commack, NY 11725-5404
Phone (631) 623-4300

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
80.94
Improvement activities
40
Cost
65.19

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey Diagnostic Radiology CurrentSince May 6, 2017 Accepting new patients
MSK Monmouth Diagnostic Radiology CurrentSince May 6, 2017 Accepting new patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Jan 1, 1994 Accepting new patients
MSK Bergen Diagnostic Radiology CurrentSince Jul 9, 2019 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

160 E 53rd St
New York, NY 10022
Phone (212) 610-0112

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
New York, NY 10017

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

633 3rd Ave
#232
New York, NY 10017
Phone (212) 639-7203

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: elis39011@mskcc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1366420713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "address_2": "BOX 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS",
        "first_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "199037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.