Individual provider Active NPI

Cristina Lisardo, NP

  • Nurse Practitioner
  • Watertown, NY
National Provider Identifier
1649157017
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
357635 Issued in NY
Practice address
670 Hazelhurst Ave
Watertown, NY 13601-1332
Phone
(954) 696-6837
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 357635 NY Primary

Addresses

Primary practice location

670 Hazelhurst Ave
Watertown, NY 13601-1332

Mailing address

670 Hazelhurst Ave
Watertown, NY 13601-1332
Phone (954) 696-6837

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
I20260311003422 NY Practitioner - Nurse Practitioner 3173006749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

830 Washington St
Watertown, NY 13601-4034
Phone (315) 785-4000

Hospital & facility affiliations

  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
357635NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Center CurrentSince Feb 1, 2026 Accepting new patients
Samaritan Medical Center Past Accepting new patients

Locations

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

Organizations & group practices 2

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": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1649157017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 HAZELHURST AVE",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011332",
            "telephone_number": "954-696-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 HAZELHURST AVE",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011332",
            "telephone_number": "954-696-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISARDO",
        "first_name": "CRISTINA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "357635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.