Individual provider Active NPI

Lizette Perez Nolt, MD

  • Family Medicine Physician
  • Parkesburg, PA
National Provider Identifier
1437594900
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD462814 Issued in PA
Practice address
950 S Octorara TRL
Parkesburg, PA 19365-2100
Phone
(610) 857-6648
Fax
(610) 857-6638
NPI assigned
May 9, 2013
Last updated
Jan 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD462814 PA Primary

Addresses

Primary practice location

950 S Octorara TRL
Parkesburg, PA 19365-2100

Mailing address

950 S Octorara TRL
Parkesburg, PA 19365-2100
Phone (610) 857-6648

Other names 1

  • Lizette Perez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180322001960 PA Practitioner - Family Practice 5496041816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University Central del Caribe Escuela de Medicina, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ingleside Medical Associates LLCGroup PAC ID 6507841954, 8 clinicians

Practice addresses (Care Compare)

200 Municipal Dr
Thorndale, PA 19372-1058
Phone (610) 383-6300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD462814PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ingleside Medical Associates LLC Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
Lancaster General Medical Group CurrentSince Mar 26, 2018 Accepting new patients
Lancaster General Medical Group CurrentSince Mar 26, 2018 Accepting new patients
Lancaster General Medical Group Current Accepting new patients

Locations

2118 Spring Valley Rd
Lancaster, PA 17601
Phone (215) 615-2222

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

1159 River Rd
#F
Marietta, PA 17547
Phone (717) 426-1131

620 Spear St
Oxford, PA 19363
Phone (610) 932-9300

4223 W Lincoln Hwy
Parkesburg, PA 19365
Phone (215) 383-6300

950 S Octorara Trl
Parkesburg, PA 19365
Phone (610) 857-6616

200 Municipal Dr
Thorndale, PA 19372
Phone (484) 889-2523

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBFEBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1437594900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S OCTORARA TRL",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193652100",
            "telephone_number": "610-857-6648",
            "fax_number": "610-857-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S OCTORARA TRL",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193652100",
            "telephone_number": "610-857-6648",
            "fax_number": "610-857-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLT",
        "first_name": "LIZETTE",
        "middle_name": "PEREZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD462814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZETTE",
            "last_name": "PEREZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Parkesburg, PA

Sources for this page

Verify at the official NPI Registry.