Active NPI
Lisa Marie Andolina, M.D.
- Emergency Medicine Physician
- Mendon, NY
National Provider Identifier
1710929302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 246515
- Practice address
- 10 Pine Holw
Emergency
Mendon, NY 14506-9769 - Phone
- (585) 905-4890
- NPI assigned
- Jun 11, 2006
- Last updated
- Mar 25, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 246515 | NY | Primary |
Addresses
Primary practice location
10 Pine Holw
Emergency
Mendon, NY 14506-9769
Mailing address
10 Pine Holw
Mendon, NY 14506-9769
Phone (585) 905-4890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02933122 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246515 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Services Network, PLLC. | Emergency Medicine | Past | Accepting new patients |
| Emergency Physicians of Nashville, PLLC | Emergency Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Nashville, TN
- NPI 1982650909
-
- Emergency Medicine Physician
- Clarksville, TN
- NPI 1902852007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364169600000",
"number": "1710929302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PINE HOLW",
"city": "MENDON",
"state": "NY",
"postal_code": "145069769",
"telephone_number": "585-905-4890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PINE HOLW",
"address_2": "EMERGENCY",
"city": "MENDON",
"state": "NY",
"postal_code": "145069769",
"telephone_number": "585-905-4890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDOLINA",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-11",
"last_updated": "2013-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "246515",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02933122",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mendon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.