Lisa Lacivita, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R069690 Issued in MD

Practice address

5755 Cedar LN
Columbia, MD 21044-2912

Phone

(410) 740-7890

Fax

(410) 740-7610

NPI assigned

Jun 5, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Professional Anesthesia Services, Inc.

  • Specialist
  • Arnold, MD
  • NPI 1053511550
  NPD (past)

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1659507572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11085 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 004",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442912",
            "telephone_number": "410-740-7890",
            "fax_number": "410-740-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACIVITA",
        "first_name": "LISA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R069690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle H Kwon, LMSW
• Jayson T Kwon
• Andrea Kwong
• Benjamin Daniel L'Ecuyer, PT, DPT
• Lisa Steinberg Laborwit, M.D.
• Monica Shanaee Lacks
• Timothy Jerome Lacy, M.D.
• Everette Darr Lafon Jr., M.D.
• Tara Lafrance
• Michael Lagonera, PTA

• Certified Registered Nurse Anesthetist in Columbia, MD
• Providers in Columbia, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.