Lisa Medoh

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R175763 Issued in MD

Practice address

11120 New Hampshire Ave
Silver Spring, MD 20904-2633

Phone

(301) 439-4422

NPI assigned

Dec 29, 2015

Last updated

Dec 29, 2015By the provider in NPPES

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 DC, MD2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medugo Health Care LLC

  • Primary Care Clinic/Center
  • Upper Marlboro, MD
  • NPI 1285343780
  Authorized official Same address or phone

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1689039075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 HOMESTEAD DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745760",
            "telephone_number": "240-486-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-439-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDOH",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R175763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Park Optical, LLC
• Medicalincs LLC (Healthlincs)
• Medicalincs LLC
• Elizabeth Medina
• Hiram Ismael Medina, D.D.S.
• Zulma Carolina Medrano-Lopez
• Medstar Health Endoscopy Center - Silver Spring, LLC
• Medstar Health Weight Management, LLC
• Medstar Health Weight Management, LLC
• Medstar Health Weight Management, LLC

• Family Nurse Practitioner in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.