NPIMap

Individual provider Active NPI

Lisa Marie Peto, APRN FNP-C

  • Family Nurse Practitioner
  • Lake Wales, FL
National Provider Identifier
1720485170
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9346305 Issued in FL
Practice address
24165 Hwy 27
Lake Wales, FL 33859-7819
Phone
(863) 696-0393
Fax
(863) 676-0275
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9346305 FL Primary

Addresses

Primary practice location

24165 Hwy 27
Lake Wales, FL 33859-7819

Mailing address

4142 Dinner Lake Way
Lake Wales, FL 33859-2102
Phone (407) 284-0271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181110000089 FL Practitioner - Nurse Practitioner 8628348364 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1255 State Rd 60
Suite 400
Lake Wales, FL 33853-4310
Phone (863) 676-8237

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • Adventhealth Home Health Home health agency, Temple Terrace, FL, CCN 107414
  • Centerwell Home Health Home health agency, Winter Haven, FL, CCN 107534
  • Vitalcaring Group Home health agency, Tampa, FL, CCN 109761
  • Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099
  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9346305FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Physician Group Inc Family CurrentSince Jul 1, 2022 Accepting new patients
Adventhealth Primary Care Network Inc Family CurrentSince Aug 1, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Karen N Phillipps MD PA PastSince Aug 27, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

1255 State Road 60 E
Ste 500
Lake Wales, FL 33853
Phone (844) 634-3627

24165 US 27
Lake Wales, FL 33859
Phone (844) 634-3627

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Interoperability endpoints

  • Direct secure messaging: lpeto74012@adventhealth.direct-ci.com

Organizations & group practices 5

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1720485170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4142 DINNER LAKE WAY",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338592102",
            "telephone_number": "407-284-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 HWY 27",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338597819",
            "telephone_number": "863-696-0393",
            "fax_number": "863-676-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "APRN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9346305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.