Lisa Fazi-Diedrich, M.D.

Primary specialty

Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X

License

MD058440L Issued in PA

Practice address

160 E Erie Ave
Philadelphia, PA 19134-1011

Phone

(215) 427-5220

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Lisa Fazi Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• STC Pediatrics LLC

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• STC Pediatrics LLC

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1528603875
  NPD
• STC Pediatrics LLC

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997
  NPD
• SCHC Pediatric Anesthesia Associates, LLC

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1700011905
  NPD (past)
• SCHC Pediatric Associates, LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1255363578
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1699786186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZI-DIEDRICH",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD058440L",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD058440L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016760420",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "FAZI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyle Faye, CRNP, DNP
• Mikhail Faynberg, DDS
• Nora Faynberg, MD
• Kristopher Scott Fayock, M.D.
• Cheyanne Fazeli, DMD
• Robert J Fazio, PHD
• Salvatore Fazio, DPM
• Samantha Fazio, DPT
• Marianne Fazioli
• Pamela Fazzio, MD

• Pediatric Anesthesiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Anesthesiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.