Individual provider Active NPI

Lisa Christine Baranski

  • Physician Assistant
  • Murphysboro, IL
National Provider Identifier
1609499615
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008553 Issued in IL
Practice address
7 S Hospital Dr
Murphysboro, IL 62966-3333
Phone
(618) 519-9200
Fax
(618) 684-2748
NPI assigned
May 26, 2020
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.008553 IL
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 085008553 IL Primary

Addresses

Primary practice location

7 S Hospital Dr
Murphysboro, IL 62966-3333

Mailing address

109 California St
PO Box 577
Carterville, IL 62918-0577
Phone (618) 519-9200

Other practice location 1

502 W Saint Louis St Ste 4
West Frankfort, IL 62896-1968
Phone (618) 937-3400

Other practice location 2

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Other practice location 3

405 Rushing Dr
Herrin, IL 62948-3730
Phone (618) 993-3300

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lbaranski24792@sih.direct-ci.com
Direct Messaging Address lbaranski24792@sih.direct-ci.com
Direct Messaging Address lbaranski24792@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20211115002784 IL Practitioner - Physician Assistant 6406245398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1006 S Division St
Carterville, IL 62918-1539
Phone (618) 985-4841

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 942-2171

7 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 687-3418

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085008553ILMDPhysician Assistant
085.008553ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Health Service and Development Corp CurrentSince Jul 10, 2023 Accepting new patients
Shawnee Health Service and Development Corp CurrentSince Jul 10, 2023 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Nov 29, 2021 Accepting new patients
Shawnee Health Service and Development Corp Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

404 S Lewis Ln
Carbondale, IL 62901
Phone (618) 319-4076

405 W Jackson St
Carbondale, IL 62901

1006 S Division St
Carterville, IL 62918
Phone (618) 985-4841

405 Rushing Dr
Herrin, IL 62948
Phone (618) 993-3300

7 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 565-1003

502 W Saint Louis St
Ste 4
West Frankfort, IL 62896
Phone (618) 937-3400

Interoperability endpoints

  • Direct secure messaging: lbaranski24792@sih.direct-ci.com
  • Direct secure messaging: lisa.baranski.1@14668.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1609499615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA ST",
            "address_2": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-519-9200",
            "fax_number": "618-985-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S HOSPITAL DR",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663333",
            "telephone_number": "618-519-9200",
            "fax_number": "618-684-2748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 W Saint Louis St Ste 4",
            "address_purpose": "LOCATION",
            "city": "West Frankfort",
            "state": "IL",
            "postal_code": "628961968",
            "country_code": "US",
            "telephone_number": "618-937-3400",
            "fax_number": "618-997-9324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-549-5361",
            "fax_number": "618-351-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Rushing Dr",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483730",
            "country_code": "US",
            "telephone_number": "618-993-3300",
            "fax_number": "618-993-0262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARANSKI",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.008553",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbaranski24792@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbaranski24792@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 Rushing Dr",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbaranski24792@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "502 W Saint Louis St Ste 4",
            "city": "West Frankfort",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628961968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murphysboro, IL

Sources for this page

Verify at the official NPI Registry.