Lisa Ann Blackwood, M.D., M.S.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0060806 Issued in CO

Practice address

3455 S Yarrow St
Lakewood, CO 80227

Phone

(303) 989-5231

NPI assigned

Apr 17, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Ann Deininger Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Dermatology

Education

Louisiana State University School of Medicine in New Orleans, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samantha Ghiselli MD PLLCGroup PAC ID 8820485261, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lblackwood@center4advderm.emadirect.md

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.

• Samantha Ghiselli MD PLLC

  • Dermatology Physician
  • Glendale, CO
  • NPI 1689253734
  Medicare reassignment Care Compare group NPD
• Center for Advanced Dermatology LLC

  • Dermatology Physician
  • Lakewood, CO
  • NPI 1497765762
  Medicare reassignment NPD
• Pure Dermatology PLLC

  • Dermatology Physician
  • Glendale, CO
  • NPI 1407363971
  NPD

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1760749683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 LARK ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701222238",
            "telephone_number": "504-343-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 S YARROW ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80227",
            "telephone_number": "303-989-5231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "0060806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DEININGER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Bitto
• Bitz Chiropractic LLC
• Jeanmarie Bizarro, MA CCC-SLP
• Joseph Louis Bjorhus, PA-C
• Brianne Black, RN
• Julia Blair, RN
• Laura Lynn Blair
• Mikaela Blair
• Ann Geralyn Blake, LMT
• Marina Blake, LPC

• Dermatology Physician in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.