Lisette Anne D'Eon, MD

Individual provider Active NPI Internal Medicine Physician · Springville, NY

NPI 1437115482 · NPPES record last updated Dec 11, 2012

Key facts

NPI
1437115482
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
185096 (NY)
Practice address
224 E Main St
Bertrand Chaffee Hospital Primary Care Clinic
Springville, NY 14141-1443
Phone
(716) 592-8140
Fax
(716) 961-3713
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Drive Medical Group LLP Internal Medicine Past
since Aug 1, 2014
Accepting new patients
Academic Medicine Services, Inc. Internal Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.medent.com/fhir/R4/3P171181

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 185096 NY Yes

Addresses

Primary practice location

224 E Main St
Bertrand Chaffee Hospital Primary Care Clinic
Springville, NY 14141-1443

Mailing address

50 Getzville Rd
Apt. C
Amherst, NY 14226-3516
Phone (716) 832-5901

Other identifiers

IdentifierTypeStateIssuer
01345179MedicaidNY

Other providers in Springville, NY

All providers in Springville, NY · Internal Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.