Individual provider Active NPI

Lisa J States, MD

  • Pediatric Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1750473591
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
MD052679L Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Radiology
Philadelphia, PA 19104-4319
Phone
(215) 590-7000
Fax
(215) 590-9348
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X MA07027600 NJ
Body Imaging Physician 2085B0100X MD052679L PA
Nuclear Radiology Physician 2085N0904X MD052679L PA
Pediatric Radiology Physician 2085P0229X MD052679L PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Radiology
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232

Other identifiers 1

IdentifierTypeStateIssuer
000155673(PA)MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080513000315 PA Practitioner - Diagnostic Radiology 1951367556 Reassigns benefits to 3 organizations
I20170421001401 NY Practitioner - Diagnostic Radiology 1951367556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
JS Weill Medical College, Cornell University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Children'S Hospital, IncGroup PAC ID 0345154399, 40 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA07027600NJMDPediatric Radiology Physician
MD052679LPAMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Geisinger Clinic CurrentSince Aug 1, 2018 Accepting new patients
Fpa Hospital Based CurrentSince Mar 21, 2017 Accepting new patients
Geisinger Clinic Nuclear Radiology CurrentSince Aug 1, 2018 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Fpa Hospital Based Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2019 Accepting new patients
Fpa Hospital Based CurrentSince Mar 21, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Jul 1, 2019 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

1001 Chesterbrook Blvd
Ste 100
Berwyn, PA 19312
Phone (610) 576-7500

100 N Academy Ave
Danville, PA 17822

402 McFarlan Rd
Ste 201
Kennett Square, PA 19348
Phone (610) 444-2665

491 Allendale Rd
Ste 104
Kng of Prussa, PA 19406
Phone (215) 860-3360

11 Friends Ln
Ste 101
Newtown, PA 18940
Phone (215) 579-1300

250 W Lancaster Ave
Ste 180
Paoli, PA 19301
Phone (610) 644-0477

1840 South St
Ste 3
Philadelphia, PA 19146
Phone (215) 546-1893

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

420 W Linfield Trappe Rd
Bldg A
Royersford, PA 19468

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

455 Woodview Rd
West Grove, PA 19390
Phone (610) 345-1960

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

777 Township Line Rd
Ste 150
Yardley, PA 19067
Phone (215) 860-3360

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1750473591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-7000",
            "fax_number": "215-590-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATES",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NJ",
            "license": "MA07027600",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PA",
            "license": "MD052679L",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD052679L",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MD052679L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000155673(PA)",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.