Individual provider Active NPI

Lisa Marie Snyder, PA-C

  • Physician Assistant
  • Chelsea, MI
National Provider Identifier
1629322169
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006960 Issued in MI
Practice address
14700 E Old US Highway 12
Chelsea, MI 48118-1185
Phone
(734) 475-1321
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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 5601006960 MI Primary

Addresses

Primary practice location

14700 E Old US Highway 12
Chelsea, MI 48118-1185

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292
Phone (616) 267-7414

Other names 1

  • Lisa Marie Lau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140604002099 MI Practitioner - Physician Assistant 0547414708 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

Practice addresses (Care Compare)

1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000

775 S Main St
SJM Chelsea Hospital
Chelsea, MI 48118-1383
Phone (734) 936-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince May 26, 2020 Accepting new patients
Regents of the University of Michigan Physician Assistant CurrentSince May 26, 2020 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

14700 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-1321

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

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.

Hospital & facility affiliations 1

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": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1629322169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 E OLD US HIGHWAY 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181185",
            "telephone_number": "734-475-1321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Lake Dr SE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495468292",
            "country_code": "US",
            "telephone_number": "616-267-7414",
            "fax_number": "616-267-7137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LAU",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.