Individual provider Active NPI

Neal M. Lisann, M.D.

  • Diagnostic Radiology Physician
  • Rego Park, NY
National Provider Identifier
1528027067
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
151666 Issued in NY
Practice address
9520 63Rd Rd Ste H
Rego Park, NY 11374-1145
Phone
(718) 755-0656
Fax
(866) 310-5525
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 151666 NY Primary

Addresses

Primary practice location

9520 63Rd Rd Ste H
Rego Park, NY 11374-1145

Mailing address

9520 63Rd Rd Ste H
Rego Park, NY 11374-1145
Phone (718) 755-0656

Other identifiers 1

IdentifierTypeStateIssuer
00932009MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050330000167 NY Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 5799731063 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
State University of New York Downstate Medical Center, 1981
Medicare assignment
May accept Medicare assignment
Group practices
Queens Medical Care Service PCGroup PAC ID 1759637846, 4 clinicians
Radiology Medical Associates PCGroup PAC ID 0840441796, 2 clinicians

Practice addresses (Care Compare)

9520 63Rd Rd
Suite H
Rego Park, NY 11374-1145
Phone (718) 730-4606

9728 63Rd Rd
Rego Park, NY 11374-1639
Phone (718) 539-3646

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive MRI of New York, P.C. Diagnostic Radiology CurrentSince Dec 1, 2020 Accepting new patients
Queens Medical Care Service PC CurrentSince May 1, 2018 Accepting new patients
Radiology Medical Associates PC Diagnostic Radiology CurrentSince Nov 7, 2012 Accepting new patients
Sure Medical PC CurrentSince Jan 5, 2020 Accepting new patients
Comprehensive MRI of New York, P.C. CurrentSince Dec 1, 2020 Accepting new patients
Maurice Pharmacy Inc PastSince Oct 6, 2010 Accepting new patients
Precision Health Inc Past Accepting new patients
Michael L. Hundert M.D. P.C. Past Accepting new patients
Health Care for All, NP in Adult Health, P.C. Past Accepting new patients
Diacore Associates of Queens Inc Past Accepting new patients
Complete Medical Ny, PC PastSince Mar 1, 2011 Accepting new patients
Nuclear Cardiac and Medical Imaging Services, PC Past Accepting new patients
Neurorays Imaging, P.C. Diagnostic Radiology Past Accepting new patients
Hilltop Medical Diagnostic and Treatment Center Past Accepting new patients
Empire Medical of Rockaway Beach Past Accepting new patients
N. S. So Island Diag GRP Past Accepting new patients
Heartbeat Medical, PC Past Accepting new patients

Locations

9425 60th Ave
Ste B4
Elmhurst, NY 11373
Phone (718) 280-9092

1710 Veterans Memorial Hwy
Islandia, NY 11749
Phone (516) 348-0996

9728 63rd Rd
Rego Park, NY 11374
Phone (347) 730-4606

9520 63rd Rd
Ste H
Rego Park, NY 11374
Phone (347) 813-4143

3974 Amboy Rd
Ste 302
Staten Island, NY 10308
Phone (347) 730-4606

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1528027067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9520 63RD RD STE H",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741145",
            "telephone_number": "718-755-0656",
            "fax_number": "866-310-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 63RD RD STE H",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741145",
            "telephone_number": "718-755-0656",
            "fax_number": "866-310-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISANN",
        "first_name": "NEAL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "151666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00932009",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.