Individual provider Active NPI

Lisa Pfefferkorn, CRNA

  • Certified Registered Nurse Anesthetist
  • Palm Springs, CA
National Provider Identifier
1477091825
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000663 Issued in CA
Practice address
1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872
Phone
(760) 323-6511
NPI assigned
Feb 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 834554 CA
Registered Nurse 163W00000X 658332 NY
Certified Registered Nurse Anesthetist 367500000X 95000663 CA Primary

Addresses

Primary practice location

1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872

Mailing address

29253 Snapdragon PL
Canyon Country, CA 91387-1858
Phone (510) 378-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170412000896 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022394725 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coachella Valley Anesthesia a Professional CorporationGroup PAC ID 5698131969, 126 clinicians

Practice addresses (Care Compare)

420 34TH St
Bakersfield, CA 93301-2237
Phone (661) 324-4647

Hospital & facility affiliations

  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
658332NYMDRegistered Nurse
95000663CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coachella Valley Anesthesia a Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Mission Nursing Anesthesia, Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Palm Springs Anesthesia Services, PC CurrentSince Apr 1, 2017 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

39700 Bob Hope Dr
Ste 204
Rancho Mirage, CA 92270
Phone (760) 346-3641

35800 Bob Hope Dr
Ste 100
Rancho Mirage, CA 92270
Phone (760) 699-5000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1477091825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29253 SNAPDRAGON PL",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913871858",
            "telephone_number": "510-378-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N INDIAN CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624872",
            "telephone_number": "760-323-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEFFERKORN",
        "first_name": "LISA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "834554",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "658332",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.