Organization Active NPI

Lisa R Kroopf MD a Professional Medical Corporation

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Monterey, CA
National Provider Identifier
1386261519
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
LISA R KROOPF MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
172 El Dorado St
Monterey, CA 93940-3118
Phone
(831) 901-3940
Fax
(831) 901-3939
NPI assigned
Jul 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Lisa Kroopf, MDNPI 1487896585
Title
Physician
Phone
(831) 901-3940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

172 El Dorado St
Monterey, CA 93940-3118

Mailing address

172 El Dorado St
Monterey, CA 93940-3118
Phone (831) 901-3940

Other identifiers 1

IdentifierTypeStateIssuer
1487896585OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200804003264 CA Part B Supplier - Clinic/Group Practice 7911322151 Receives reassigned benefits from 1 practitioner
Practice locations: Monterey, CA
O20220111000334 CA DME Supplier - Physician - Interventional Pain Management 7911322151 Practice locations: Monterey, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1386261519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 EL DORADO ST",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403118",
            "telephone_number": "831-901-3940",
            "fax_number": "831-901-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 EL DORADO ST",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403118",
            "telephone_number": "831-901-3940",
            "fax_number": "831-901-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA R KROOPF MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-04",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "KROOPF",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "831-901-3940",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487896585",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.