Lisa A Broome, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0002687 Issued in MD

Practice address

16 N la Plata CT
La Plata, MD 20646-4283

Phone

(301) 392-3330

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa A Kenney Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precision Orthopedics and Sports MedicineGroup PAC ID 2860658192, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Charles Regional Medical Center Hospital, La Plata, MD, CCN 210035

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lbroome@precisionmsk.emadirect.md

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.

• Precision Orthopedics and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Laurel, MD
  • NPI 1962766899
  Medicare reassignment Care Compare group
• Precision Orthopedics and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Cumberland, MD
  • NPI 1407603954
  NPD
• Up Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Laurel, MD
  • NPI 1134672769
  NPD (past)

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

• Civista Medical Center Inc

  • Rural Acute Care Hospital
  • La Plata, MD
  • NPI 1992701825
  Care Compare affiliation
• Civista Medical Center, Inc.

  • Physical Therapist
  • La Plata, MD
  • NPI 1689071219

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1598985178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N LA PLATA CT",
            "address_2": "P.O. BOX 2188",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206464283",
            "telephone_number": "301-392-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N LA PLATA CT",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206464283",
            "telephone_number": "301-392-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KENNEY",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kwame Asante Boateng, RPH
• Kara Bradford
• Kathleen Brady, PTA A224
• Jenae Brendle
• Brooks Michael Briel, MD
• Rudee Latrina Brothers
• Joanne Brown
• Melissa Brown, N.P.
• Dominique Gabrielle Bryant
• Btsquared, LLC

• Physician Assistant in La Plata, MD
• Providers in La Plata, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.