Individual provider Active NPI

Lisa Amy Friedman, RN, MSN, CPNP

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1619970662
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP111980 Issued in TX
Practice address
333 N Santa Rosa
San Antonio, TX 78207-3108
Phone
(210) 704-2190
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 662780 TX
Pediatric Nurse Practitioner 363LP0200X AP111980 TX Primary

Addresses

Primary practice location

333 N Santa Rosa
San Antonio, TX 78207-3108

Mailing address

315 N San Saba
Suite 1135
San Antonio, TX 78207-3154
Phone (210) 704-2190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050427000612 TX Practitioner - Nurse Practitioner 2769421932 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
662780TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Apr 7, 2014 Accepting new patients
River City Pediatric Emergency Physicians, PLLC Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Pediatrics Past Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

Interoperability endpoints

  • Direct secure messaging: lfriedman415899@christushealth.direct-ci.net

Organizations & group practices 3

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1619970662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE 1135",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-704-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "LISA",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "662780",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP111980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.