Individual provider Active NPI

Lisette Alfaro-Berg, MD

  • Hospitalist Physician
  • Dallas, TX
National Provider Identifier
1437189727
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
M1463 Issued in TX
Practice address
3600 Gaston Ave
#550
Dallas, TX 75246-1904
Phone
(214) 821-1177
Fax
(214) 821-1193
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X M1463 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
#550
Dallas, TX 75246-1904

Mailing address

PO Box 849931
Dallas, TX 75284-0001
Phone (214) 821-1177

Other identifiers 2

IdentifierTypeStateIssuer
175726201MedicaidTX
8M5818OtherTXBCBS

Other names 1

  • Lisette Alfaro Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20080822000636 NY Practitioner - Internal Medicine 3870523301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6000

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

Hospital & facility affiliations

  • Wynn Hospital Hospital, Utica, NY, CCN 330044

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
246975NYMDLicensed Practical Nurse
M1463TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Jul 1, 2010 Accepting new patients
MVHS Inc CurrentSince Jul 1, 2010 Accepting new patients
National Primary Care Network, PA Hospitalist Past Accepting new patients
Cap Medical Group PLLC Past Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

Interoperability endpoints

  • Direct secure messaging: lalfaroberg13071@mvhealthsystem.direct-ci.com

Organizations & group practices 4

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 1

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1437189727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849931",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840001",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "#550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461904",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFARO-BERG",
        "first_name": "LISETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M1463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175726201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8M5818",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISETTE",
            "last_name": "ALFARO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.