NPIMap

Individual provider Active NPI

Lisa Melnik Pearson, PA-C

  • Surgical Physician Assistant
  • Stamford, CT
National Provider Identifier
1497928931
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3649 Issued in CT
Practice address
1 Blachley Rd
Stamford, CT 06902-0002
Phone
(203) 705-0715
Fax
(203) 705-0717
NPI assigned
Apr 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3649 CT
Surgical Physician Assistant 363AS0400X 013905 NY
Surgical Physician Assistant 363AS0400X 3649 CT Primary

Addresses

Primary practice location

1 Blachley Rd
Stamford, CT 06902-0002

Mailing address

PO Box 29234
New York, NY 10087-9234
Phone (203) 705-0715

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct
Direct Messaging Address lpearson15299@direct.HSS.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200914002286 CT Practitioner - Physician Assistant 1355412651 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Blachley Rd
Stamford, CT 06902-0002
Phone (212) 774-7598

Hospital & facility affiliations

  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270
  • Stamford Hospital Hospital, Stamford, CT, CCN 070006
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3649CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 30, 2020 Accepting new patients
Yale University CurrentSince Jul 30, 2020 Accepting new patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Aug 8, 2022 Accepting new patients
New York Society for the Relief of Ruptured and Crippled Maintain Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1 Blachley Rd
Stamford, CT 06902
Phone (203) 705-0750

541 E 71st St
New York, NY 10021
Phone (212) 606-1136

541 E 71st St
#4
New York, NY 10021
Phone (212) 774-2837

535 E 70th St
New York, NY 10021

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • Direct secure messaging: lpearson15299@direct.hss.edu
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: lpearson24502@stamfordhealth.direct-ci.com

Organizations & group practices 6

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 12

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": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1497928931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29234",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879234",
            "telephone_number": "203-705-0715",
            "fax_number": "203-705-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020002",
            "telephone_number": "203-705-0715",
            "fax_number": "203-705-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "LISA",
        "middle_name": "MELNIK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2022-10-12",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3649",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "013905",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 East 70th Street",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 East 70th Street",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpearson15299@direct.HSS.edu",
            "affiliation": "N",
            "endpointDescription": "lpearson15299@direct.HSS.edu",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 East 70th Street",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.