Individual provider Active NPI

Lisa Marie Covello, PA-C

  • Physician Assistant
  • Stamford, CT
National Provider Identifier
1750036646
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
30 Buxton Farm Rd Ste 220
Stamford, CT 06905-1230
Phone
(203) 658-6051
Fax
(888) 397-2148
NPI assigned
Feb 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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 Primary

Addresses

Primary practice location

30 Buxton Farm Rd Ste 220
Stamford, CT 06905-1230

Mailing address

14 Applebee Rd Apt 1
Stamford, CT 06905-3513
Phone (203) 921-9709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230207003549 NY Practitioner - Physician Assistant 4284006859 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BSS MD CT PLLC CurrentSince Mar 24, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Aug 8, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Aug 8, 2022 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

30 Buxton Farm Rd
Ste 220
Stamford, CT 06905

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: licovello@montefioredirect.com

Organizations & group practices 4

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": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1750036646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 APPLEBEE RD APT 1",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053513",
            "telephone_number": "203-921-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BUXTON FARM RD STE 220",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051230",
            "telephone_number": "203-658-6051",
            "fax_number": "888-397-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVELLO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.