Individual provider Active NPI

Lisa L Pierce, CRNP

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1578848305
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9646 Issued in CT
Practice address
2800 Main St
Bridgeport, CT 06606-4201
Phone
(860) 696-5159
Fax
(860) 696-5140
NPI assigned
Oct 12, 2011
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9646 CT Primary
Family Nurse Practitioner 363LF0000X 209-015864 IL

Addresses

Primary practice location

2800 Main St
Bridgeport, CT 06606-4201

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337

Other practice location 1

85 Seymour St Ste 227
Hartford, CT 06106-5501
Phone (860) 696-5169

Other names 1

  • Lisa M Lycksell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121217000245 PA Practitioner - Nurse Practitioner 0446424147 Reassigns benefits to 1 organization
I20210621002998 CT Practitioner - Nurse Practitioner 0446424147 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

85 Seymour St
Hartford, CT 06106-5501

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9646CTMDFamily Nurse Practitioner
209-015864ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 2, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 24, 2015 Accepting new patients
Yale University CurrentSince Aug 15, 2022 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Mar 24, 2015 Accepting new patients
Hartford Hospital CurrentSince Jul 1, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Aug 2, 2021 Accepting new patients
Yale University CurrentSince Aug 15, 2022 Accepting new patients
Hartford Hospital CurrentSince Jul 1, 2023 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

85 Seymour St
Ste 227
Hartford, CT 06106
Phone (860) 696-4306

85 Seymour St
Ste 125
Hartford, CT 06106
Phone (860) 696-0090

85 Seymour St
Hartford, CT 06106
Phone (860) 246-4029

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3400 Spruce St
Fl 3
Philadelphia, PA 19104

440 E Marshall St
Ste 210
West Chester, PA 19380
Phone (215) 662-3490

Interoperability endpoints

  • Direct secure messaging: llycksell147393@direct.rush.rush-health.com
  • Direct secure messaging: lpierce581481@direct.ynhh.org
  • Direct secure messaging: lisa.pierce@xdr.hhchealthdirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1578848305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "860-696-5159",
            "fax_number": "860-696-5140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Seymour St Ste 227",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061065501",
            "country_code": "US",
            "telephone_number": "860-696-5169",
            "fax_number": "860-696-5140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9646",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-015864",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LYCKSELL",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.