Individual provider Active NPI

Lisa A Lyle, FNP

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1366471039
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331058 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621
Phone
(585) 922-2575
Fax
(585) 922-5033
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F331058 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621

Mailing address

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-2575

Other identifiers 6

IdentifierTypeStateIssuer
000918223001OtherHEALTH NOW
109180DLOtherPCARE
NP0883OtherNYPREFERRED CARE
7104853OtherNYAETNA
7599537OtherGHI
P019331058OtherEXCELLUS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lisa.lyle@rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120615000002 NY Practitioner - Nurse Practitioner 3476717869 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F331058NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jun 1, 2012 Accepting new patients
The Unity Hospital of Rochester CurrentSince Jan 22, 2022 Accepting new patients
Rochester General Hospital Family CurrentSince Jun 1, 2012 Accepting new patients
Cornerstone Urgent Care Center LLC CurrentSince Aug 14, 2019 Accepting new patients
Rochester General Hospital Current Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Western New York Medical Practice P.C. CurrentSince Feb 11, 2020 Accepting new patients

Locations

2968 Chili Ave
Rochester, NY 14624
Phone (585) 207-0088

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1455 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-4103

Interoperability endpoints

  • Direct secure messaging: llyle25060@direct.rochesterregional.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1366471039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-2575",
            "fax_number": "585-922-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-2575",
            "fax_number": "585-922-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLE",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000918223001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCARE",
            "identifier": "109180DL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "NP0883",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7104853",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7599537",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "P019331058",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa.lyle@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1425 Portland Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.