Individual provider Active NPI

Lisage Georges, ARNP

  • Family Nurse Practitioner
  • Lauderhill, FL
National Provider Identifier
1770102634
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11019688 Issued in FL
Practice address
1295 NW 40TH Ave Ste 200
Lauderhill, FL 33313-5801
Phone
(954) 583-4710
Fax
(954) 583-4711
NPI assigned
Apr 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NJDCATEMP-000832 NJ
Family Nurse Practitioner 363LF0000X APRN11019688 FL Primary

Addresses

Primary practice location

1295 NW 40TH Ave Ste 200
Lauderhill, FL 33313-5801

Mailing address

4360 Pomelo Blvd
Boynton Beach, FL 33436-1612
Phone (786) 659-9597

Other practice location 1

4360 Pomelo Blvd
Boynton Beach, FL 33436-1612
Phone (786) 659-9597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220906000434 FL Practitioner - Nurse Practitioner 1658755905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

168 N Powerline Rd
Pompano Beach, FL 33069-5713
Phone (954) 970-8805

2272 N Congress Ave
Boynton Beach, FL 33426-8604
Phone (561) 737-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NJDCATEMP-000832NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Oct 15, 2023 Accepting new patients
Broward Community and Family Health Centers Inc CurrentSince Aug 31, 2022 Accepting new patients
Broward Community and Family Health Centers Inc Current Accepting new patients
Broward Community and Family Health Centers Inc CurrentSince Aug 31, 2022 Accepting new patients
MD Now Medical Centers Inc CurrentSince Oct 15, 2023 Accepting new patients

Locations

2272 N Congress Ave
Boynton Beach, FL 33426
Phone (561) 737-1927

5010 Hollywood Blvd
Hollywood, FL 33021

5010 Hollywood Blvd
Ste 100B
Hollywood, FL 33021
Phone (954) 967-0028

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1295 NW 40th Ave
#200
Lauderhill, FL 33313
Phone (954) 583-4710

168 N Powerline Rd
Pompano Beach, FL 33069
Phone (954) 633-0023

5800 W Hallandale Beach Blvd
West Park, FL 33023
Phone (954) 966-3939

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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.

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1770102634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 POMELO BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334361612",
            "telephone_number": "786-659-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 NW 40TH AVE STE 200",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333135801",
            "telephone_number": "954-583-4710",
            "fax_number": "954-583-4711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4360 Pomelo Blvd",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334361612",
            "country_code": "US",
            "telephone_number": "786-659-9597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGES",
        "first_name": "LISAGE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "NJDCATEMP-000832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11019688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

Verify at the official NPI Registry.