Active NPI
Lisa R. Braun, PA-C
- Medical Physician Assistant
- Wahpeton, ND
National Provider Identifier
1720075666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PAC0387
- Practice address
- 332 2ND Ave N
Wahpeton, ND 58075-4528 - Phone
- (701) 642-7000
- NPI assigned
- Oct 5, 2005
- Last updated
- Apr 2, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6824570 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0493 | SD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Family Medicine Physician
- Rosholt, SD
- NPI 1538344734
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.