Individual provider Active NPI

Lisa Tubbs, PAC

  • Physician Assistant
  • Reynoldsburg, OH
National Provider Identifier
1619211307
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2014 Baltimore Reynoldsburg Rd
Reynoldsburg, OH 43068-3261
Phone
(614) 522-6900
NPI assigned
Nov 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH Primary

Addresses

Primary practice location

2014 Baltimore Reynoldsburg Rd
Reynoldsburg, OH 43068-3261

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141
Phone (419) 520-2495

Other identifiers 1

IdentifierTypeStateIssuer
0129137MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130219000388 OH Practitioner - Physician Assistant 5799930921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth Urgent Care LLCGroup PAC ID 3476733700, 129 clinicians

Practice addresses (Care Compare)

1120 Polaris Pkwy
Suite 100
Columbus, OH 43240-4042
Phone (614) 847-1120

130 University Dr
Suite 1300
Marion, OH 43302-1104
Phone (740) 692-4440

1710 Columbus Pike
Delaware, OH 43015-2726
Phone (740) 549-2700

2030 Stringtown Rd
Grove City, OH 43123-3993
Phone (614) 883-0160

Merit-based Incentive Payment System (MIPS)

Final score
86.16 of 100Reported as group
Quality
79.15
Promoting interoperability
100
Improvement activities
40
Cost
74.72

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1619211307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141",
            "telephone_number": "419-520-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 BALTIMORE REYNOLDSBURG RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683261",
            "telephone_number": "614-522-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "LISA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129137",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

Verify at the official NPI Registry.