Lisa D. Mahon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008455 Issued in NY

Practice address

5719 Widewaters Pkwy
Syracuse, NY 13214-1880

Phone

(315) 251-3100

Fax

(315) 449-9923

NPI assigned

Aug 30, 2005

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

Other names 1

• Lisa Doyle Former name

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Group practices

Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Syracuse Orthopedic Specialists, PLLCGroup PAC ID 6406760073, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCR Home Care Home health agency, East Syracuse, NY, CCN 337119
• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Syracuse Orthopedic Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Syracuse, NY
  • NPI 1669410379
  Medicare reassignment Care Compare group
• Select PT, OT & SLP Rehabilitation Ny PLLC

  • Rehabilitation Clinic/Center
  • Hudson, NY
  • NPI 1457026353
  Care Compare group
• Syracuse Orthopedic Specialists, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Liverpool, NY
  • NPI 1689953135
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • Oneonta, NY
  • NPI 1649575549
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • East Syracuse, NY
  • NPI 1841585114
  Care Compare affiliation
• L Woerner Inc

  • Home Health Agency
  • East Syracuse, NY
  • NPI 1982978342
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1689667222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141880",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141880",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHON",
        "first_name": "LISA",
        "middle_name": "D.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DOYLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Muhammad Junaid Mahboob, MBBS
• Alycia Marie Maher, M.S., CCC-SLP
• Marie Julia Maher, L.C.S.W., C.A.S.A.C.
• Ahmed Mahgoub, M.D
• Tallat Mahmood, M.D.
• Marshall Mahon, MD
• Kimberly Fox Mahr, CRNA
• Shylaja Maini
• Trisha Maini, MD
• Julianna Maiorano, M.S. CCC-SLP

• Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.