Individual provider Active NPI

Trina Marie Lisko, DO

  • Physical Medicine & Rehabilitation Physician
  • Vineland, NJ
National Provider Identifier
1457471377
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MB0842700 Issued in NJ
Practice address
352 S Delsea Dr Unit C
Vineland, NJ 08360-5308
Phone
(856) 690-1616
Fax
(856) 896-6107
NPI assigned
Apr 2, 2007
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X OS014298 PA
Physical Medicine & Rehabilitation Physician 208100000X 25MB0842700 NJ Primary

Addresses

Primary practice location

352 S Delsea Dr Unit C
Vineland, NJ 08360-5308

Mailing address

352 S Delsea Dr Unit C
Vineland, NJ 08360-5308
Phone (856) 690-1616

Other practice location 1

556 Egg Harbor Rd
Suite A
Sewell, NJ 08080-2326
Phone (856) 589-0650

Other practice location 2

1004 Haddonfield Rd
Cherry Hill, NJ 08002-2746
Phone (856) 690-1616 ext. 6021

Other identifiers 1

IdentifierTypeStateIssuer
102212120-0002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081215000002 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 5890857593 Reassigns benefits to 1 organization
I20090116000477 PA Practitioner - Physical Medicine and Rehabilitation 5890857593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Rowan University School of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

298 S Delsea Dr
Vineland, NJ 08360-4568
Phone (856) 690-1616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB0842700NJMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Physical Medicine & Rehabilitation CurrentSince Sep 1, 2008 Accepting new patients
Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC CurrentSince Nov 18, 2019 Accepting new patients
Einstein Practice Plan Inc CurrentSince Sep 1, 2008 Accepting new patients
Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC CurrentSince Nov 18, 2019 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
United Therapy Centers, Inc. Physical Medicine & Rehabilitation Past Accepting new patients
Community Neurology Associates PC Past Accepting new patients

Locations

1004 Haddonfield Rd
Cherry Hill, NJ 08002
Phone (609) 662-7733

556 Egg Harbor Rd
Ste A
Sewell, NJ 08080
Phone (856) 286-2000

298 S Delsea Dr
Vineland, NJ 08360
Phone (356) 690-1616

352 S Delsea Dr
Unit C
Vineland, NJ 08360
Phone 8566901616 ext. 6021

1200 W Tabor Rd
Philadelphia, PA 19141
Phone (215) 456-9470

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

Interoperability endpoints

  • Direct secure messaging: trina.lisko@poasnj.eclinicaldirectplus.com

Organizations & group practices 7

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 6

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1457471377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR UNIT C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605308",
            "telephone_number": "856-690-1616",
            "fax_number": "856-896-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR UNIT C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605308",
            "telephone_number": "856-690-1616",
            "fax_number": "856-896-6107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "556 Egg Harbor Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080802326",
            "country_code": "US",
            "telephone_number": "856-589-0650",
            "fax_number": "856-589-2720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Haddonfield Rd",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022746",
            "country_code": "US",
            "telephone_number": "856-690-1616 x6021",
            "fax_number": "856-896-6107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISKO",
        "first_name": "TRINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OS014298",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB0842700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102212120-0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.