Individual provider Active NPI

Lisa M. Simonds, M.D.

  • Family Medicine Physician
  • Union Grove, WI
National Provider Identifier
1497779375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29896-020 Issued in WI
Practice address
1120 Main St
Union Grove, WI 53182-1328
Phone
(261) 878-4424
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29896-020 WI Primary

Addresses

Primary practice location

1120 Main St
Union Grove, WI 53182-1328

Mailing address

1120 Main St
Union Grove, WI 53182-1328
Phone (261) 878-4424

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070327000092 WI Practitioner - Family Practice 3971607284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

1120 Main St
Union Grove, WI 53182-1328
Phone (262) 878-4424

Hospital & facility affiliations

  • Ascension at Home Home health agency, Milwaukee, WI, CCN 527187
  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29896-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Family Medicine CurrentSince Apr 2, 2007 Accepting new patients
Ascension All Saints Hospital, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3821 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-8460

1120 Main St
Union Grove, WI 53182
Phone (262) 687-8000

Organizations & group practices 2

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 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497779375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 MAIN ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821328",
            "telephone_number": "261-878-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MAIN ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821328",
            "telephone_number": "261-878-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONDS",
        "first_name": "LISA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29896-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union Grove, WI

Sources for this page

Verify at the official NPI Registry.