Active NPI
Lisa M Marroney, PA-C
- Surgical Physician Assistant
- Randallstown, MD
National Provider Identifier
1528029600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- C0002996
- Practice address
- 5401 Old Court Rd
Dept. of Surgery
Randallstown, MD 21133-5103 - Phone
- (410) 521-2200
- NPI assigned
- Mar 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | C0002996 | MD | Primary |
Addresses
Primary practice location
5401 Old Court Rd
Dept. of Surgery
Randallstown, MD 21133-5103
Mailing address
5401 Old Court Rd
Attn: Credentialing
Randallstown, MD 21133-5103
Phone (410) 601-5524
Other names 1
- Lisa M Jacobson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704
Hospital & facility affiliations
- University of Maryland Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0002996 | MD | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Hospital Center, Inc. | Past | Accepting new patients | |
| Saint Joseph Medical Center , Inc. | Past | Accepting new patients | |
| St. Joseph Physician Enterprise | Past | Accepting new patients |
Interoperability endpoints
- lmarroney131913@direct.umm.edu
- https://fhir-myrecord.cerner.com/r4/136fea15-c667-40bc-9ed2-b1115d62123b/
Organizations & group practices 5
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.
-
- Emergency Care Clinic/Center
- Baltimore, MD
- NPI 1679512909
-
- Colon & Rectal Surgery Physician
- Towson, MD
- NPI 1932425634
-
- Pulmonary Disease Physician
- Randallstown, MD
- NPI 1740290980
-
- Multi-Specialty Clinic/Center
- Towson, MD
- NPI 1699862961
-
- Multi-Specialty Clinic/Center
- Towson, MD
- NPI 1518143304
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1174660120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1528029600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 OLD COURT RD",
"address_2": "ATTN: CREDENTIALING",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211335103",
"telephone_number": "410-601-5524",
"fax_number": "410-601-8946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 OLD COURT RD",
"address_2": "DEPT. OF SURGERY",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211335103",
"telephone_number": "410-521-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRONEY",
"first_name": "LISA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MD",
"license": "C0002996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "JACOBSON",
"middle_name": "M",
"credential": "PA-C",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Randallstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- 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.