Lisa Zack, M.D.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

ME56408 Issued in FL

Practice address

801 Anchor Rode Dr
Ste 100
Naples, FL 34103-2742

Phone

(239) 263-1717

Fax

(239) 403-9410

NPI assigned

Jun 21, 2005

Last updated

Sep 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisa D Zack MD PAGroup PAC ID 3274629340, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

72.45 of 100Reported as individual

Quality

49.91

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lzack@flcda.emadirect.md

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.

• Lisa D Zack MD PA

  • Dermatology Physician
  • Naples, FL
  • NPI 1518189927
  Medicare reassignment Care Compare group NPD
• Florida Coastal Surgery Center, Inc

  • Ambulatory Surgical Clinic/Center
  • Naples, FL
  • NPI 1003812686
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1467458984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ANCHOR RODE DR",
            "address_2": "STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341032742",
            "telephone_number": "239-263-1717",
            "fax_number": "239-403-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ANCHOR RODE DR",
            "address_2": "STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341032742",
            "telephone_number": "239-263-1717",
            "fax_number": "239-403-9410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19910 S Tamiami Trl Ste B",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "339284140",
            "country_code": "US",
            "telephone_number": "239-676-8677",
            "fax_number": "239-676-8680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZACK",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME56408",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME56408",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "ME56408",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "FL",
            "license": "ME56408",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME56408",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME56408",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "713505",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PA",
            "identifier": "568740",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0387142",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08856",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "ZE2985",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Naples",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "801 Anchor Rode Dr",
            "address_2": "Ste 100",
            "city": "Naples",
            "state": "FL",
            "country_code": "US",
            "postal_code": "341032742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dermatopathology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Dermatopathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.