Lisette Manning, MD

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11005160 Issued in FL

Practice address

600 S Dixie Hwy Ste 103
Boca Raton, FL 33432-6034

Phone

(561) 430-3629

NPI assigned

Nov 23, 2019

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Genesis Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Boynton Beach, FL
  • NPI 1447578125

  Single Specialty

  Medicare reassignment NPD
• Genesis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Boca Raton, FL
  • NPI 1073982831
  NPD

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

{
    "created_epoch": "1574467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1669018750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 E OCEAN AVE STE 409",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334355017",
            "telephone_number": "561-735-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S DIXIE HWY STE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334326034",
            "telephone_number": "561-430-3629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10220 W Sample Rd",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330653940",
            "country_code": "US",
            "telephone_number": "954-340-1123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1440 Coral Ridge Dr # 121",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330715433",
            "country_code": "US",
            "telephone_number": "954-543-1760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNING",
        "first_name": "LISETTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie L Manevitch, LMT
• Julia Allnutt Manfre, LMHC
• Michelle Mankoff, LMFT
• Jenna L Manning, PA-C
• Kalan Manning
• Daniel Alexander Mannion, MD
• Manor Care of Boca Raton FL LLC
• Lisa Ann Mansell, LCSW
• Zaneb Mansha
• Elsie J Manton, LCSW

• Family Nurse Practitioner in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.