Individual provider Active NPI

Lisa Marie Zerdelian, NP

  • Pediatric Nurse Practitioner
  • Woonsocket, RI
National Provider Identifier
1407162464
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN01301 Issued in RI
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
Fax
(401) 235-6899
NPI assigned
Aug 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X NPP37576 RI
Pediatric Nurse Practitioner 363LP0200X APRN01301 RI Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Other practice location 1

360 Kingstown Rd Unit 101
Narragansett, RI 02882-3258
Phone (401) 789-6492

Other practice location 2

1 River St
Wakefield, RI 02879-3214
Phone (401) 783-0523

Other practice location 3

186 Providence St
West Warwick, RI 02893-2508
Phone (401) 615-2804

Other identifiers 1

IdentifierTypeStateIssuer
LZ83262MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20101129000013 RI Practitioner - Nurse Practitioner 3173719507 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Sep 9, 2010 Accepting new patients
Thundermist Health Center CurrentSince Sep 9, 2010 Accepting new patients
Thundermist Health Center Past Accepting new patients

Locations

360 Kingstown Rd
Unit 101
Narragansett, RI 02882
Phone (401) 783-3334

1 River St
Wakefield, RI 02879
Phone (401) 783-0523

186 Providence St
West Warwick, RI 02893
Phone (401) 615-2800

450 Clinton St
Woonsocket, RI 02895

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA
  • Direct secure messaging: lisa.zerdelian@thundermist.eclinicaldirectplus.com

Organizations & group practices 3

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": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1407162464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Kingstown Rd Unit 101",
            "address_purpose": "LOCATION",
            "city": "Narragansett",
            "state": "RI",
            "postal_code": "028823258",
            "country_code": "US",
            "telephone_number": "401-789-6492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 River St",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028793214",
            "country_code": "US",
            "telephone_number": "401-783-0523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "186 Providence St",
            "address_purpose": "LOCATION",
            "city": "West Warwick",
            "state": "RI",
            "postal_code": "028932508",
            "country_code": "US",
            "telephone_number": "401-615-2804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZERDELIAN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "RI",
            "license": "NPP37576",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN01301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LZ83262",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.