NPIMap

Individual provider Active NPI

Jordan M Lisella, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Albany, NY
National Provider Identifier
1720043946
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
4301087211 Issued in MI
Practice address
1367 Washington Ave Ste 200
Albany, NY 12206-1043
Phone
(518) 489-2666
Fax
(518) 489-5933
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 4301087211 MI Primary

Addresses

Primary practice location

1367 Washington Ave Ste 200
Albany, NY 12206-1043

Mailing address

1367 Washington Ave
Suite 200
Albany, NY 12206-1069
Phone (518) 489-2666

Other practice location 1

4 Medical Park Dr Ste 200
Malta, NY 12020-5004
Phone (518) 489-2666

Other practice location 2

92 East Ave
Saratoga Springs, NY 12866-2615
Phone (518) 489-2666

Other identifiers 1

IdentifierTypeStateIssuer
02865736MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070823000249 NY Practitioner - Orthopedic Surgery 5698788180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
State University of New York Downstate Medical Center, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Region Orthopaedic Associates, PCGroup PAC ID 3779496393, 67 clinicians

Practice addresses (Care Compare)

146 Jefferson HTS
Suite 101
Catskill, NY 12414-1215
Phone (518) 943-0667

Hospital & facility affiliations

  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013
  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406

Merit-based Incentive Payment System (MIPS)

Final score
82.41 of 100Reported as group
Quality
56.02
Promoting interoperability
100
Improvement activities
40
Cost
85.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301087211MIMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Region Ambulatory Surgery Center, L.L.C. Current Accepting new patients
Capital Region Orthopaedic Associates, PC Foot and Ankle Surgery CurrentSince Aug 20, 2007 Accepting new patients

Locations

1367 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 489-2666

146 Jefferson Hts
Ste 101
Catskill, NY 12414
Phone (518) 943-0667

4 Medical Park Dr
Ste 200
Malta, NY 12020
Phone (518) 289-2171

92 East Ave
Saratoga Springs, NY 12866
Phone (518) 584-0295

3757 Carman Rd
Schenectady, NY 12303
Phone (518) 346-0002

Interoperability endpoints

  • Direct secure messaging: jordan.lisella.1@28317.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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1720043946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061069",
            "telephone_number": "518-489-2666",
            "fax_number": "518-489-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE STE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061043",
            "telephone_number": "518-489-2666",
            "fax_number": "518-489-5933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Medical Park Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Malta",
            "state": "NY",
            "postal_code": "120205004",
            "country_code": "US",
            "telephone_number": "518-489-2666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "92 East Ave",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128662615",
            "country_code": "US",
            "telephone_number": "518-489-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISELLA",
        "first_name": "JORDAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MI",
            "license": "4301087211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02865736",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.