NPIMap

Individual provider Active NPI

Lisa Juliann Carlson Weber, PA-C

  • Physician Assistant
  • Wausau, WI
National Provider Identifier
1376771139
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2463 Issued in WI
Practice address
425 Pine Ridge Blvd
Suite 209
Wausau, WI 54401-4123
Phone
(715) 847-0400
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2463 WI Primary

Addresses

Primary practice location

425 Pine Ridge Blvd
Suite 209
Wausau, WI 54401-4123

Mailing address

PO Box 8004
Wausau, WI 54402-8004
Phone (715) 847-2304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090813000811 WI Practitioner - Physician Assistant 5395899058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians

Practice addresses (Care Compare)

4005 Community Ctr Dr
Weston, WI 54476-4139
Phone (715) 241-5400

425 Pine Ridge Blvd
Wausau, WI 54401-4123

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2463WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medical Group, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Aspirus Specialist Inc. Past Accepting new patients
Aspirus Specialists, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

425 Wind Ridge Dr
Wausau, WI 54401
Phone (715) 675-3391

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Ste 209
Wausau, WI 54401
Phone (715) 845-4606

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

4005 Community Center Dr
Ste 203
Weston, WI 54476
Phone (715) 241-5470

Interoperability endpoints

  • Direct secure messaging: lcarlson20129@direct.aspirus.org

Organizations & group practices 8

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 12

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1376771139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8004",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544028004",
            "telephone_number": "715-847-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 209",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-847-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "LISA",
        "middle_name": "JULIANN CARLSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.