Individual provider Active NPI

Lisa Anne Lima, M.D.

  • Anesthesiology Physician
  • Lackland a F B, TX
National Provider Identifier
1568652287
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M8292 Issued in TX
Practice address
2200 Bergquist Dr
Ste 1
Lackland a F B, TX 78236-9907
Phone
(210) 292-5212
Fax
(210) 292-7986
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD-14404 HI
Anesthesiology Physician 207L00000X M8292 TX Primary

Addresses

Primary practice location

2200 Bergquist Dr
Ste 1
Lackland a F B, TX 78236-9907

Mailing address

415 Eagleview Boulevard
Suite 108
Exton, PA 19341-2239
Phone (800) 872-8626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151104001508 FL Practitioner - Anesthesiology 7214184969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arkansas College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-14404HIMDAnesthesiology Physician
M8292TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Oct 1, 2019 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiology CurrentSince Aug 28, 2015 Accepting new patients
Indian River Health Services Inc Anesthesiology CurrentSince Oct 1, 2019 Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Ste 244
Vero Beach, FL 32960
Phone (772) 778-9621

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: llima69526@epicdirect.hf.org

Organizations & group practices 3

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 4

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1568652287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 EAGLEVIEW BOULEVARD",
            "address_2": "SUITE 108",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412239",
            "telephone_number": "800-872-8626",
            "fax_number": "610-524-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "STE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-5212",
            "fax_number": "210-292-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMA",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": "MD-14404",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M8292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland a F B, TX

Sources for this page

Verify at the official NPI Registry.