Individual provider Active NPI

Lisa M Grahek-Lindsey, PAC

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1467418590
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
113896 Issued in MO
Practice address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone
(314) 652-4100
NPI assigned
Apr 26, 2006
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 113896 MO Primary

Addresses

Primary practice location

915 N Grand Blvd
Saint Louis, MO 63106-1621

Mailing address

10004 Kennerly Road
Suite 330 a
St Louis, MO 63128-2175
Phone (314) 543-5963

Other practice location 1

24 Behlmann Lake Ct
Florissant, MO 63034-2862
Phone (314) 718-9947

Other practice location 2

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100208000794 MO Practitioner - Physician Assistant 4981747227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South County Anesthesia Associates LTDGroup PAC ID 4082510383, 81 clinicians
Life Line Surgical Services LLCGroup PAC ID 8022151463, 2 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1000

901 W Commercial St
Kennett, MO 63857-1100
Phone (314) 718-9947

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
113896MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South County Anesthesia Associates, LTD. CurrentSince Nov 28, 2024 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients
Inpatient Consultants of Missouri Inc Past Accepting new patients

Locations

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

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 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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1467418590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY ROAD",
            "address_2": "SUITE 330 A",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631282175",
            "telephone_number": "314-543-5963",
            "fax_number": "314-525-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Behlmann Lake Ct",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630342862",
            "country_code": "US",
            "telephone_number": "314-718-9947",
            "fax_number": "314-653-1791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHEK-LINDSEY",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "113896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.