Lisa M Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1216 Issued in NE

Practice address

7120 S 69TH St Ste 101a
Lincoln, NE 68516-3868

Phone

(402) 520-8955

Fax

(833) 471-5257

NPI assigned

Sep 23, 2005

Last updated

Feb 1, 2024By the provider in NPPES

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 identifiers 2

Other names 1

• Lisa M Hassebroek Former name

Medicare fee-for-service enrollment

Enrolled in NE

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medelite Urgent Care LLCGroup PAC ID 0345696589, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.johnson.1@28242.direct.athenahealth.com

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.

• Medelite Urgent Care L.L.C.

  dba ME Wellness Care & Aesthetics

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1346940210
  Medicare reassignment Care Compare group NPD Authorized official
• Nebraska Emergency Medicine PC

  • Emergency Medicine Physician
  • Lincoln, NE
  • NPI 1669576831
  Medicare reassignment

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1619963709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 S 69TH ST STE 101A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163868",
            "telephone_number": "402-499-2883",
            "fax_number": "833-471-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 S 69TH ST STE 101A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163868",
            "telephone_number": "402-520-8955",
            "fax_number": "833-471-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "23174",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00716684",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HASSEBROEK",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristy Johnson, DO
• Latrentis Zarnay Johnson
• Leah Johnson, OTD, OTR/L
• Lenette Johnson
• Linda Johnson
• Lloyd Derontae Johnson
• Luke Alan Johnson, CRNA
• Madison Marie Johnson
• Makenna Maxine Johnson
• Mariah Danielle Johnson, LMHP, LMFT

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.