Lisa Marie Conway, PA-C
Individual provider Active NPI Medical Physician Assistant · Lexington, KY
NPI 1457533283 · NPPES record last updated Dec 2, 2020
Key facts
- NPI
- 1457533283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 50.002674 (OH)
- Practice address
- 2716 Old Rosebud Rd
Lexington, KY 40509-8008 - Phone
- (859) 543-1577
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Baptist Health Medical Group Inc
Practice addresses (Care Compare)
2716 Old Rosebud Rd
Lexington, KY 40509-8003
4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3094
Phone (859) 260-4390
Hospital & facility affiliations
- Baptist Health Lexington
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.29 of 100
- Quality
- 87.32
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080205000185 | KY | Practitioner - Physician Assistant | 1052493624 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.002674 | OH | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Health Medical Group Inc | Current |
Accepting new patients | |
| Baptist Health Medical Group Inc | Current |
Accepting new patients | |
| Bluegrass Bariatric Surgical Associates, PLLC | Past | Accepting new patients |
Locations
4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390
2716 Old Rosebud Rd
Ste 350
Lexington, KY 40509
Phone (859) 543-1577
Interoperability endpoints
- lconway6392@bhkydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 50.002674 | OH | Yes |
Addresses
Primary practice location
2716 Old Rosebud Rd
Lexington, KY 40509-8008
Mailing address
2716 Old Rosebud Rd
Lexington, KY 40509-8008
Phone (859) 543-1577
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50.002674 | Other | OH | OH LICENSE |
| 7100036940 | Medicaid | KY | |
| PA1092 | Other | KY | LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lconway6392@bhkydirect.com |
NPI Registry JSON
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1457533283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2716 OLD ROSEBUD RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405098008",
"telephone_number": "859-543-1577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2716 OLD ROSEBUD RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405098008",
"telephone_number": "859-543-1577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OH",
"license": "50.002674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH LICENSE",
"identifier": "50.002674",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100036940",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PA1092",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lconway6392@bhkydirect.com",
"affiliation": "N",
"address_1": "2716 Old Rosebud Rd",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405098008",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lexington, KY
- Continuing Care Hospital, Inc.
- Continuum Medical PLLC
- Malissa Claudette Contreras
- Danielle Marie Conway
- Kimberly V. Conway
- Rajeana Michele Conway
- Darwin L Conwell
- Carol Elizabeth Conyers
- Emma Paige Conyers
- Kimberly Ann Cook-Lee
All providers in Lexington, KY · Medical Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.