Individual provider Active NPI

Gina Lucien-Lissone, ANP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1669457289
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F302642 Issued in NY
Practice address
1 Penn PLZ
8TH FL
New York, NY 10119-0002
Phone
(917) 583-7878
Fax
(866) 491-2280
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F302642 NY Primary

Addresses

Primary practice location

1 Penn PLZ
8TH FL
New York, NY 10119-0002

Mailing address

656 Lenox Rd
North Baldwin, NY 11510-1019
Phone (516) 771-3756

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
I20041112000537 NY Practitioner - Nurse Practitioner 9436113115 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F302642NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services, PC PastSince Mar 10, 2009 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8825/brand/4/csg/1/fhir/r4
  • Direct secure messaging: ms_glucien@landmarkhealth-direct.org
  • Direct secure messaging: gina.lucien.1@30409.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1669457289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 LENOX RD",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101019",
            "telephone_number": "516-771-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ",
            "address_2": "8TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "917-583-7878",
            "fax_number": "866-491-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIEN-LISSONE",
        "first_name": "GINA",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F302642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.