Lisa Park

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

A168789 Issued in CA

Practice address

5 Bon Air Rd Ste 101
Larkspur, CA 94939-1134

Phone

(415) 924-2515

NPI assigned

Apr 1, 2015

Last updated

Dec 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Colorectal Surgery (Proctology)

Education

Albany Medical College of Union University, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

Merit-based Incentive Payment System (MIPS)

Final score

81.03 of 100Reported as subgroup

Quality

80.86

Promoting interoperability

76

Improvement activities

40

Cost

75.91

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpark205045@direct-ucsfmedicalcenter.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regents Univ of California UCSF

  dba UCSF Physician Group

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1124439807

  Surgery

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  Care Compare affiliation

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1568857142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 101",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391134",
            "telephone_number": "415-924-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 101",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391134",
            "telephone_number": "415-924-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "57.027085",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A168789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ogrady, M.S.CCC-SLP
• Pacific Heart Surgery
• Austin Vincent Padua, DPT
• Allison Marie Palandrani, D.P.T.
• Jacob M Palmquist, MD
• Ramon A. Partida, M.D.
• Frank Peronetto, PT
• Margaret Emily Peterson, R.N.F.A.
• Steve Pickell, P.T.
• Mykaela Poe

• Colon & Rectal Surgery Physician in Larkspur, CA
• Providers in Larkspur, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.

Verify at the official NPI Registry.