Individual provider Active NPI

Lisa Berry Lasater, CRNA

  • Certified Registered Nurse Anesthetist
  • Festus, MO
National Provider Identifier
1497761183
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
072604 Issued in IL
Practice address
1400 US Highway 61
Festus, MO 63028-4100
Phone
(636) 933-1000
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 072604 IL Primary

Addresses

Primary practice location

1400 US Highway 61
Festus, MO 63028-4100

Mailing address

PO Box 350
Crystal City, MO 63019-0350
Phone (636) 933-1000

Other identifiers 3

IdentifierTypeStateIssuer
P00356067OtherMORR MEDICARE
917183808MedicaidMO
430687077008OtherMOTRICARE

Other names 1

  • Lisa Berry Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050517000128 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385685718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians
Mid-West Anesthesia Partners LLCGroup PAC ID 1557842911, 42 clinicians

Practice addresses (Care Compare)

100 Medical PLZ
Lake Saint Louis, MO 63367-1366
Phone (636) 625-5200

1130 Town and Country Commons Dr
Town and Country, MO 63017-8200
Phone (636) 256-0320

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 453-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072604ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 11, 2006 Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients

Locations

400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1497761183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "630190350",
            "telephone_number": "636-933-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY LASATER",
        "first_name": "LISA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "072604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00356067",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "917183808",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "430687077008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BERRY",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.