Lisa M. Mitchell, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA456 Issued in MA

Practice address

38 Vanderbilt Ave
Norwood, MA 02062

Phone

(718) 762-2800

Fax

(781) 762-2800

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.mitchell.npi1639287352.reliant@direct.optumcare.masshiway.net

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.

• Medical Laser Solutions

  • Physician Assistant
  • Norwood, MA
  • NPI 1912598608
  NPD Authorized official
• Sturdy Health, Inc.

  • Internal Medicine Physician
  • Mansfield, MA
  • NPI 1871515874
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1639287352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 VANDERBILT AVE",
            "address_2": "SUITE F",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "02062",
            "telephone_number": "718-762-2800",
            "fax_number": "781-762-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 VANDERBILT AVE",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "02062",
            "telephone_number": "718-762-2800",
            "fax_number": "781-762-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LISA",
        "middle_name": "M.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "000456",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP",
            "identifier": "41053",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie J Miller
• Michael Alan Miller, D.C.
• Tanya Miller
• Malaka Mims, LICSW
• Gary F Mitchell, M.D.
• Prajakta Prakash Mithbavkar, PT, MS
• Aubrey McKenzie Mixon, MT-BC
• MMDS of Boston, LLC
• Mobility Solutions, Inc.
• Modderno Eyecare, P.C.

• Physician Assistant in Norwood, MA
• Providers in Norwood, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.