Lissette E. Tirado, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000729 Issued in GA

Practice address

625 Beaver Ruin Rd NW
Suite C
Lilburn, GA 30047-3467

Phone

(770) 935-4443

Fax

(770) 935-4475

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Village Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Covington, GA
  • NPI 1942036314
  NPD (past)
• Village Podiatry Group, L.L.C.

  • Podiatrist
  • Roswell, GA
  • NPI 1508846718
  NPD (past)
• Pediatrix Medical Group of Georgia, P.C.

  • Maternal & Fetal Medicine Physician
  • Sunrise, FL
  • NPI 1972695260
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1508866765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BEAVER RUIN RD NW",
            "address_2": "SUITE C",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473467",
            "telephone_number": "770-935-4443",
            "fax_number": "770-935-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BEAVER RUIN RD NW",
            "address_2": "SUITE C",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473467",
            "telephone_number": "770-935-4443",
            "fax_number": "770-935-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRADO",
        "first_name": "LISSETTE",
        "middle_name": "E.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000729",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "GA",
            "license": "000729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000761736A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Three in One Medical
• Three in One Medical
• Thrive Nutrition, LLC
• Through Thick & Thin Perinatal Services, LLC
• Thryvmed Solutions LLC
• Einat Toledano
• Christine I Tolu-Ajayi, MD
• Tom Noga MD Mental Health for Life PC
• Konnie A Torbahn, PH.D.
• Total Life Wellness LLC

• Podiatrist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.