Individual provider Active NPI

Lisa M Moore, PA-C

  • Physician Assistant
  • Auburn, ME
National Provider Identifier
1659456630
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1497 Issued in ME
Practice address
690 Minot Ave Ste 1
Auburn, ME 04210-3922
Phone
(207) 783-1328
Fax
(207) 786-4332
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 800 MA
Physician Assistant 363A00000X PA1497 ME Primary
Physician Assistant 363A00000X 9108417 FL

Addresses

Primary practice location

690 Minot Ave Ste 1
Auburn, ME 04210-3922

Mailing address

690 Minot Ave
Auburn, ME 04210-3922
Phone (207) 783-1328

Other identifiers 1

IdentifierTypeStateIssuer
1659456630MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL, ME3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100609000307 MA Practitioner - Physician Assistant 8022114289 Reassigns benefits to 2 organizations
I20190109000820 FL Practitioner - Physician Assistant 8022114289
I20201209003285 ME Practitioner - Physician Assistant 8022114289 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

690 Minot Ave
Auburn, ME 04210-3922
Phone (207) 783-1328

Hospital & facility affiliations

  • Central Maine Medical Center Hospital, Lewiston, ME, CCN 200024

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3595AZMDPhysical Therapist
800MAMDAudiologist
9108417FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Feb 20, 2021 Accepting new patients
Lahey Clinic, Inc CurrentSince Apr 16, 2010 Accepting new patients
Lahey Clinic, Inc. CurrentSince Apr 16, 2010 Accepting new patients
Central Maine Medical Center CurrentSince Feb 20, 2021 Accepting new patients
Rumford Hospital CurrentSince Jun 22, 2020 Accepting new patients
Bridgton Hospital CurrentSince Jun 22, 2020 Accepting new patients
Health Consulting Associates LLC PastSince Oct 20, 2015 Accepting new patients
Prohealth Select, Inc. Physician Assistant PastSince Dec 17, 2020 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

260 Cochituate Rd
Framingham, MA 01701
Phone (508) 628-9660

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

690 Minot Ave
#1
Auburn, ME 04210
Phone (207) 783-1328

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

176 Livermore Falls Rd
Farmington, ME 04938
Phone 2077777740 ext. 3208

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 10

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1659456630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-783-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE STE 1",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-783-1328",
            "fax_number": "207-786-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "800",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1497",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9108417",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659456630",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.