Lisa Evans Carson, NP

Individual provider Active NPI Nurse Practitioner · Webster, MA

NPI 1649244237 · NPPES record last updated Nov 16, 2020

Key facts

NPI
1649244237
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
RN181340 (MA)
Practice address
336 Thompson Rd
Webster, MA 01570-1509
Phone
(508) 943-5224
Fax
(508) 949-2211
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20131204000028 MA Practitioner - Nurse Practitioner 3173609450 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN181340MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Nurse Practitioner Current
since Oct 10, 2013
Accepting new patients
Umass Memorial Medical Group, Inc. Current
since Oct 10, 2013
Accepting new patients

Locations

336 Thompson Rd
Webster, MA 01570
Phone (508) 943-0382

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: lcarson22348@umassmemorial.direct-ci.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN181340 MA
Nurse Practitioner 363L00000X RN181340 MA Yes

Addresses

Primary practice location

336 Thompson Rd
Webster, MA 01570-1509

Mailing address

PO Box 415348
Boston, MA 02241-0001
Phone (800) 225-8885

Other identifiers

IdentifierTypeStateIssuer
0348091MedicaidMA

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address lcarson22348@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Other providers in Webster, MA

All providers in Webster, MA · Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.