Individual provider Active NPI

Lissa M Jean-Pierre, MD

  • General Practice Physician
  • Largo, FL
National Provider Identifier
1720077019
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME85417 Issued in FL
Practice address
13220 Belcher Rd S Unit 1
Largo, FL 33773-1677
Phone
(727) 351-4894
Fax
(727) 351-4897
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME85417 FL Primary

Addresses

Primary practice location

13220 Belcher Rd S Unit 1
Largo, FL 33773-1677

Mailing address

5400 Pinehurst Dr
Spring Hill, FL 34606-3833
Phone (352) 277-5305

Other practice location 1

13220 Belcher Rd S Unit 15
Largo, FL 33773-1678
Phone (727) 469-7920

Other identifiers 1

IdentifierTypeStateIssuer
260573200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20040326000139 FL Practitioner - General Practice 6002706397 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME85417FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associatesmd Medical Group Inc CurrentSince Feb 1, 2020 Accepting new patients
Associatesmd Medical Group Inc CurrentSince Feb 1, 2020 Accepting new patients
Delray Family Practice Inc General Practice PastSince May 1, 2008 Accepting new patients
Unity Healthcare LLC Past Accepting new patients
Dynamic Medical Services Inc PastSince Jan 2, 2004 Accepting new patients
Complete Local Specialty Care, Inc Past Accepting new patients
Preventive Health Center Inc PastSince Oct 10, 2003 Accepting new patients
Access Health Care LLC PastSince Apr 1, 2022 Accepting new patients
Community Care Resources, Inc. General Practice Past Accepting new patients

Locations

4780 SW 64th Ave
Ste 101
Davie, FL 33314

4780 SW 64th Ave
Ste 103
Davie, FL 33314

333 NW 70th Ave
Ste 206
Plantation, FL 33317
Phone (954) 797-6333

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JICADA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEGBA

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1720077019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 PINEHURST DR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346063833",
            "telephone_number": "352-277-5305",
            "fax_number": "352-606-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13220 BELCHER RD S UNIT 1",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731677",
            "telephone_number": "727-351-4894",
            "fax_number": "727-351-4897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13220 Belcher Rd S Unit 15",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337731678",
            "country_code": "US",
            "telephone_number": "727-469-7920",
            "fax_number": "727-293-4121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN-PIERRE",
        "first_name": "LISSA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME85417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260573200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.