Active NPI
Lissa Kate Lubinski, M.D.
- Hospitalist Physician
- Port Angeles, WA
National Provider Identifier
1528254588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- MD60088515
- Practice address
- 240 W Front St Ste a
Port Angeles, WA 98362-2609 - Phone
- (360) 452-7891
- Fax
- (360) 452-8087
- NPI assigned
- Sep 23, 2007
- Last updated
- Mar 31, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD60088515 | WA | |
| Hospitalist Physician | 208M00000X | MD60088515 | WA | Primary |
Addresses
Primary practice location
240 W Front St Ste a
Port Angeles, WA 98362-2609
Mailing address
240 W Front St Ste a
Port Angeles, WA 98362-2609
Phone (360) 452-7891
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302615 | Other | WA | L&I |
| 2010122 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 6, 2017 through Nov 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- lissa.lubinski@54061924810756.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490918400000",
"number": "1528254588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 W FRONT ST STE A",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983622609",
"telephone_number": "360-452-7891",
"fax_number": "360-452-8087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 W FRONT ST STE A",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983622609",
"telephone_number": "360-452-7891",
"fax_number": "360-452-8087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUBINSKI",
"first_name": "LISSA",
"middle_name": "KATE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-23",
"last_updated": "2017-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD60088515",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WA",
"license": "MD60088515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "302615",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2010122",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.