Lisa S Graham, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

42312-20 Issued in WI

Practice address

5007 Matterhorn Drive
Duluth, MN 55811-3812

Phone

(218) 720-3553

Fax

(218) 786-9375

NPI assigned

Jan 30, 2006

Last updated

Aug 23, 2010By the provider in NPPES

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 2

Other names 1

• Lisa S. Macdonald Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Relf Eyecare Specialists PAGroup PAC ID 0749193290, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Relf Eyecare Specialists PA

  • Ophthalmology Physician
  • Hermantown, MN
  • NPI 1215972617
  Medicare reassignment Care Compare group NPD
• Eye Clinic of Racine, LTD.

  • Ophthalmology Physician
  • Mount Pleasant, WI
  • NPI 1417928169
  NPD (past)
• Optical Dept. of Eye Clinic of Racine, LTD.

  • Eyewear Supplier
  • Racine, WI
  • NPI 1629049150
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1720059603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007 MATTERHORN DRIVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113812",
            "telephone_number": "218-720-3553",
            "fax_number": "218-786-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5007 MATTERHORN DRIVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113812",
            "telephone_number": "218-720-3553",
            "fax_number": "218-786-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LISA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "42312",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "42312-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33333100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837658100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MACDONALD",
            "middle_name": "S.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason A Goulet, OT
• Maryjean Goulet, MSED
• Steven L Graber, D.D.S.
• Katherine M Grafing, RD LD
• Cheryl L.M Graham, MSW, LICSW
• Allison Grainger
• Rebecca Lynn Grams
• Katelyn Gramstad
• Susan Rose Gran, LICSW
• Nicole Granberg

• Ophthalmology Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.