Individual provider Active NPI

Lissette Ramirez, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1780004150
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA056797 Issued in PA
Practice address
841 E Hunting Park Ave FL 2
Philadelphia, PA 19124-4800
Phone
(215) 537-7695
Fax
(267) 686-4071
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA056797 PA Primary

Addresses

Primary practice location

841 E Hunting Park Ave FL 2
Philadelphia, PA 19124-4800

Mailing address

1412-22 Fairmount Avenue
Philadelphia, PA 19130-2908
Phone (215) 684-5344

Other practice location 1

2340 E Allegheny Ave
Philadelphia, PA 19134-4433
Phone (215) 423-6670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lissette.ramirez.p1@direct.dvch.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20141219001685 PA Practitioner - Physician Assistant 3072836212 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056797PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Community Health, Inc. CurrentSince Oct 27, 2014 Accepting new patients
Delaware Valley Community Health, Inc. CurrentSince Oct 27, 2014 Accepting new patients
Temple Physicians Inc CurrentSince May 1, 2016 Accepting new patients
Temple Physician Inc. CurrentSince May 1, 2016 Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

2340 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 423-6670

841 E Hunting Park Ave
Fl 2
Philadelphia, PA 19124
Phone (215) 537-7695

1412 Fairmount Ave
Philadelphia, PA 19130
Phone (215) 235-9600

Interoperability endpoints

  • Direct secure messaging: lissette.ramirez.p1@direct.dvch.nextgenshare.com

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1780004150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412-22 FAIRMOUNT AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "215-684-5344",
            "fax_number": "215-232-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E HUNTING PARK AVE FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191244800",
            "telephone_number": "215-537-7695",
            "fax_number": "267-686-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2340 E Allegheny Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191344433",
            "country_code": "US",
            "telephone_number": "215-423-6670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "LISSETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lissette.ramirez.p1@direct.dvch.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "841 E Hunting Park Ave Fl 2",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191244800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.