Individual provider Active NPI

Lisa Marie Canecchia, ACNP

  • Acute Care Nurse Practitioner
  • Mount Kisco, NY
National Provider Identifier
1639483423
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F430527-1 Issued in NY
Practice address
400 E Main St
Mount Kisco, NY 10549-3477
Phone
(914) 666-1042
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F430527-1 NY Primary

Addresses

Primary practice location

400 E Main St
Mount Kisco, NY 10549-3477

Mailing address

1330 1St Ave
Apt 629
New York, NY 10021-4742

Other practice location 1

1275 York Ave
C1179
New York, NY 10065-6007
Phone (212) 639-3552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110318000086 NY Practitioner - Nurse Practitioner 9234312984 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F430527-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Timothy Okelley MD PC CurrentSince Jan 14, 2025 Accepting new patients
Memorial Anesthesiology Group CurrentSince Dec 23, 2010 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2025 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2020 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

155 Crystal Run Rd
Middletown, NY 10941

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
#C1179
New York, NY 10065
Phone (212) 639-3552

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

300 Community Dr
Plandome, NY 11030

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: lcanecchia230120@direct.optum.com
  • Direct secure messaging: lcanecchia503499@northwell.direct-ci.com

Organizations & group practices 6

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 2

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1639483423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 1ST AVE",
            "address_2": "APT 629",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493477",
            "telephone_number": "914-666-1042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_2": "C1179",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-3552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANECCHIA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430527-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.