Lisa Mack, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101270275 Issued in VA

Practice address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Phone

(571) 231-3162

NPI assigned

Mar 2, 2017

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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 1

Specialty

Emergency Medicine

Education

Columbia University College of Physicians and Surgeons, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Emergency Physicians PCGroup PAC ID 7618870312, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virginia Hospital Center Hospital, Arlington, VA, CCN 490050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Commonwealth Emergency Physicians PC

  • Emergency Medicine Physician
  • Leesburg, VA
  • NPI 1598723082

  DC

  Medicare reassignment Care Compare group
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC

  Medicare reassignment

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

• Virginia Hospital Center Arlington Health System

  • General Acute Care Hospital
  • Arlington, VA
  • NPI 1790785996
  Care Compare affiliation

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1366982852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101270275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Luther, M.D.
• Bella Hoangdung Ly, DDS
• Kai-Wood Ma, MD
• Jason Alexander Macdonnell, M.D.
• Jacob Macgregor, CRNA
• John Rico Bustamante Magpantay, MD
• Michael Malabad, PA-S
• Hanaa Sadik Malaty, RPH
• Paola Cristina Maldonado, APRN
• Ashley L Maltez-Laurienti, PSY.D.

• Emergency Medicine Physician in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.