Lisa Jane Gillis, MD

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

C152190 Issued in CA

Practice address

601 5TH St S
St Petersburg, FL 33701-4804

Phone

(727) 767-8491

NPI assigned

Oct 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Geriatric Medicine

Education

Dalhousie University, Faculty of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgillis189217@orlandohealth.medalliesdirect.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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Glen Burnie, MD
  • NPI 1285752121
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • MC Lean, VA
  • NPI 1376815472
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Pediatric Physician Services, Inc.

  • Pediatrics Physician
  • St Petersburg, FL
  • NPI 1770532798

  Clinical Genetics (M.D.)

  NPD (past)

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1639680614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-8491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 Valley Childrens Pl Ste 117",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368761",
            "country_code": "US",
            "telephone_number": "559-353-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "LISA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "C152190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9300 Valley Childrens Pl Ste 117",
            "city": "Madera",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936368761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick M Gill, MD
• Taylor Rae Gillespie
• Edward Roger Gillett, M.D.
• Silas Gilliam, OTR/L
• Krista Jane Gillis, MD
• Renee C Gillombardo, LMFT
• Danielle Gillylan
• Jennifer Gilman, NBC-HWC, FMCHC, MH
• Patricia A Gilroy, M.D.
• Natalie Gilsinger, PA-C

• Clinical Genetics (M.D.) Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Genetics (M.D.) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.