Lise Phan, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

DR.0064212 Issued in CO

Practice address

1015 N 1St Ave
Suite B
Arcadia, CA 91006

Phone

(626) 598-3770

Fax

(626) 598-3770

NPI assigned

May 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA, CO, MT, IA, TN, AR, IL, KY, NC, WI10 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 10

Specialty

Neurology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Neuromonitoring Services of America IncGroup PAC ID 1850452905, 19 clinicians

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

WakemedGroup PAC ID 7315937612, 72 clinicians

Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians

West Coast Neurology, IncGroup PAC ID 6204067010, 15 clinicians

Denver Health and Hospital AuthorityGroup PAC ID 4688583578, 830 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
• Northbay Medical Center Hospital, Fairfield, CA, CCN 050367
• Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
• Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
• Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: lphan304446@direct.dhha.org
• Direct secure messaging: lisephan@wcn.allscriptsdirect.net
• Direct secure messaging: lphan58229@direct.crmcwy.org

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.

• Northbay Healthcare Group

  dba dba NorthBay Medical Center

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• West Coast Neurology, Inc

  • Neurology Physician
  • South Pasadena, CA
  • NPI 1467897322
  Medicare reassignment Care Compare group NPD
• Denver Health and Hospital Authority

  • General Practice Physician
  • Denver, CO
  • NPI 1477569838
  Medicare reassignment Care Compare group NPD
• Wakemed

  dba WakeMed Professional Physicians Staff

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1194907717
  Medicare reassignment Care Compare group NPD
• Aspirus Medical Group, Inc.

  dba Aspirus Womens Health

  • Clinic/Center
  • Wausau, WI
  • NPI 1003021452
  Medicare reassignment Care Compare group
• Neuromonitoring Services of America, Inc

  • Neurology Physician
  • Colorado Springs, CO
  • NPI 1134307531

  CA, IA, IL, KY, MT, TN

  Medicare reassignment Care Compare group
• Mercy Medical Center-Dubuque

  dba MercyOne Dubuque Medical Center

  • General Acute Care Hospital
  • Dubuque, IA
  • NPI 1659348506
  Medicare reassignment NPD
• Mercy Specialty Clinic

  dba MercyOne Specialty Care

  • Multi-Specialty Clinic/Center
  • Clinton, IA
  • NPI 1386832764
  Medicare reassignment NPD
• Providence Health & Services Mt

  dba St Patrick Hospital Rehab

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment NPD
• Northbay Healthcare Group

  dba NorthBay VacaValley Hospital

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Northbay Healthcare Group

  dba NorthBay Health Urgent Care

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Fairfield, CA
  • NPI 1780736736
  NPD
• Aspirus Medical Group, Inc.

  dba Wausau Heart & Lung Surgeons

  • Clinic/Center
  • Wausau, WI
  • NPI 1235421918
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Casa Colina Hospital and Centers for Healthcare

  • Rehabilitation Hospital
  • Pomona, CA
  • NPI 1821075870
  Care Compare affiliation
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  Care Compare affiliation
• Northbay Healthcare Group

  dba dba NorthBay Medical Center

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1073172201
  Care Compare affiliation
• Uch-MHS

  dba UCHealth Emergency Room - Powers

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1124518113
  Care Compare affiliation
• Uch-MHS

  dba Memorial Health System

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1144397134
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1154030732
  Care Compare affiliation
• Uch-MHS

  dba UCHealth Emergency Room - Fountain

  • General Acute Care Hospital
  • Fountain, CO
  • NPI 1295225274
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1316506231
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1407532559
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1518526441
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1538958400
  Care Compare affiliation

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1487031100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N 1ST AVE",
            "address_2": "SUITE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-598-3770",
            "fax_number": "626-598-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N 1ST AVE",
            "address_2": "SUITE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-598-3770",
            "fax_number": "626-598-3770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Spruce St Ste J",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024047",
            "country_code": "US",
            "telephone_number": "406-327-3350",
            "fax_number": "406-327-3355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044597",
            "country_code": "US",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-6190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MT",
            "license": "MED-PHYS-LIC-85782",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A147823",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2025-00021",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A147823",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0064212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lphan58229@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lphan58229@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy Anh Pham, MD
• Tina Pham
• Vivian Pham
• Phamily Marriage and Family Therapy Professional Corporation
• Dat Phan
• Pharmapain, Inc
• Pharmapain, Inc.
• Philip W Au DDS Inc
• Alyssa Phillips
• Andrew F. Phillips, M.D.

• Neurology Physician in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.