Lisa E Connery, MD
Individual provider Active NPI Anesthesiology Physician · Plattsburg, NY
NPI 1619973294 · NPPES record last updated Jan 13, 2021
Key facts
- NPI
- 1619973294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- ME94486 (FL)
- Practice address
- 75 Beekman Street
Plattsburg, NY 12901-1438 - Phone
- (518) 561-2000
- Fax
- (518) 562-7542
- NPI assigned
- Jun 28, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in NY, FL, ND, NM, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040506001709 | NY | Practitioner - Hospitalist |
6901895820 | Reassigns benefits to 2 organizations |
| I20161201000103 | FL | Practitioner - Anesthesiology | 6901895820 | Reassigns benefits to 2 organizations |
| I20181205000358 | ND | Practitioner - Critical Care (Intensivists) | 6901895820 | Reassigns benefits to 1 organization |
| I20181207002362 | NM | Practitioner - Hospitalist |
6901895820 | |
| I20191213002114 | CA | Practitioner - Critical Care (Intensivists) | 6901895820 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME94486 | FL | MD | Anesthesiology Physician |
| G63224 | CA | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Alexius Medical Center | Current |
Accepting new patients | |
| Champlain Valley Physicians Hospital Medical Center | Anesthesiology | Current |
Accepting new patients |
| Treasure Coast Anesthesia Group PA | Anesthesiology | Current |
Accepting new patients |
| St. Alexius Medical Center | Current |
Accepting new patients | |
| Enloe Medical Center | Current |
Accepting new patients | |
| Enloe Medical Center | Current |
Accepting new patients | |
| Alice Hyde Medical Center | Current | Accepting new patients | |
| Alice Hyde Medical Center | Current |
Accepting new patients | |
| Hospital Physician Services of Florida PA | Current |
Accepting new patients | |
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Enloe Medical Center | Past | Accepting new patients | |
| Champlain Valley Physicians Hospital Medical Center | Past | Accepting new patients | |
| North American Partners in Anesthesia LLP | Anesthesiology | Past | Accepting new patients |
| Summit Anesthesia Associates PA | Anesthesiology | Past | Accepting new patients |
| Alice Hyde Medical Center | Past | Accepting new patients |
Locations
1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470
8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212
10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853
200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618
200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
969 State Route 11
Moira, NY 12957
Phone (518) 529-7847
75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100
Interoperability endpoints
- lisa.connery@hca4.eclinicaldirectplus.com
- lconnery50036@enloedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MA07981200 | NJ | |
| Anesthesiology Physician | 207L00000X | 189380 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | G63224 | CA | |
| Anesthesiology Physician | 207L00000X | ME94486 | FL | Yes |
Addresses
Primary practice location
75 Beekman Street
Plattsburg, NY 12901-1438
Mailing address
75 Beekman Street
Plattsburg, NY 12901-1438
Phone (518) 561-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01829923 | Medicaid | NY | |
| 0149942 | Medicaid | NJ |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.