Ellen Segal Lisman, PA-C

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MA003319L Issued in PA

Practice address

2701 Holme Ave
Suite 203
Philadelphia, PA 19152-2029

Phone

(215) 331-0515

Fax

(215) 331-8144

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ellen R Segal Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1366482531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOLME AVE",
            "address_2": "SUITE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522029",
            "telephone_number": "215-331-0515",
            "fax_number": "215-331-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOLME AVE",
            "address_2": "SUITE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522029",
            "telephone_number": "215-331-0515",
            "fax_number": "215-331-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISMAN",
        "first_name": "ELLEN",
        "middle_name": "SEGAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003319L",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MA003319L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASST LICENSE #",
            "identifier": "1045793",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "SEGAL",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer M Lisberger, MACCC/SLP
• Dee Ann S Lisby, MD
• Izolda Lishansky, MD
• Louise Marie Lisi, M.D.
• Rachel Lisker
• Rebecca S Lisowski, CRNP
• Benjamin Liss, M.D.
• Ira Liss, DMD
• Nadia A Liss, DMD
• Nathan Liss, MD

• Nephrology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.