Individual provider Active NPI

Lisa Marie Warack, PA-C

  • Physician Assistant
  • West Branch, MI
National Provider Identifier
1740303205
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004189 Issued in MI
Practice address
2463 S M 30
West Branch, MI 48661-9312
Phone
(989) 343-3261
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004189 MI Primary

Addresses

Primary practice location

2463 S M 30
West Branch, MI 48661-9312

Mailing address

4790 W M 76
West Branch, MI 48661-8921
Phone (989) 345-2791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000436 MI Practitioner - Physician Assistant 6608821426 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2463 S M
Suite 30
West Branch, MI 48661-9312
Phone (989) 345-3660

335 E Houghton Ave
West Branch, MI 48661-1127
Phone (989) 343-3730

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Emergency Physicians LLP Physician Assistant CurrentSince Apr 11, 2014 Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Oct 1, 2023 Accepting new patients
Mymichigan Medical Center Gladwin Physician Assistant CurrentSince Dec 9, 2022 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Dec 9, 2022 Accepting new patients

Locations

75 Remit Dr
Ste 6895
Chicago, IL 60675

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Ste 2
Gladwin, MI 48624
Phone (989) 246-6455

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2375 S M 30
West Branch, MI 48661
Phone (989) 343-3790

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

335 E Houghton Ave
West Branch, MI 48661
Phone (989) 343-3154

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1740303205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 W M 76",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486618921",
            "telephone_number": "989-345-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2463 S M 30",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619312",
            "telephone_number": "989-343-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARACK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

Verify at the official NPI Registry.