Individual provider Active NPI

Lisa R. Braun, PA-C

  • Medical Physician Assistant
  • Wahpeton, ND
National Provider Identifier
1720075666
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAC0387 Issued in ND
Practice address
332 2ND Ave N
Wahpeton, ND 58075-4528
Phone
(701) 642-7000
NPI assigned
Oct 5, 2005
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0493 SD
Physician Assistant 363A00000X 9723 MN
Medical Physician Assistant 363AM0700X PAC0387 ND Primary

Addresses

Primary practice location

332 2ND Ave N
Wahpeton, ND 58075-4528

Mailing address

PO Box 21
104 W 3Rd Street
Rosholt, SD 57260-0021
Phone (605) 537-4350

Other identifiers 1

IdentifierTypeStateIssuer
6824570MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0493SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Kass Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1720075666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21",
            "address_2": "104 W 3RD STREET",
            "city": "ROSHOLT",
            "state": "SD",
            "postal_code": "572600021",
            "telephone_number": "605-537-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 2ND AVE N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754528",
            "telephone_number": "701-642-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "LISA",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0493",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9723",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6824570",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahpeton, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.