NPIMap

Individual provider Active NPI

Katie Ann Lisabeth, PA-C

  • Medical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1780123968
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA061808 Issued in PA
Practice address
5140 Liberty Ave Ste 102
Pittsburgh, PA 15224-2215
Phone
(412) 681-2300
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 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 MA061808 PA Primary

Addresses

Primary practice location

5140 Liberty Ave Ste 102
Pittsburgh, PA 15224-2215

Mailing address

5140 Liberty Ave Ste 102
Pittsburgh, PA 15224-2215
Phone (412) 681-2300

Other identifiers 1

IdentifierTypeStateIssuer
13974792OtherCAQH

Other names 1

  • Katie Ann Polaski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210125003163 PA Practitioner - Physician Assistant 0648526186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-3457

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-6581

420 E N Ave
Pittsburgh, PA 15212-4746

62 Greenbriar Dr
Suite 1
Leechburg, PA 15656-8209
Phone (724) 845-7765

Hospital & facility affiliations

  • Ahn Wexford Hospital Hospital, Wexford, PA, CCN 390334
  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050
  • Allegheny Valley Hospital Hospital, Natrona, PA, CCN 390032

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Jan 18, 2021 Accepting new patients
Allegheny Clinic CurrentSince Jan 18, 2021 Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

5140 Liberty Ave
Ste 102
Pittsburgh, PA 15224
Phone (412) 359-3445

12311 Perry Hwy
Wexford, PA 15090
Phone (878) 332-4143

Interoperability endpoints

  • Direct secure messaging: klisabeth357055@direct.ahn.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1780123968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 LIBERTY AVE STE 102",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242215",
            "telephone_number": "412-681-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 LIBERTY AVE STE 102",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242215",
            "telephone_number": "412-681-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISABETH",
        "first_name": "KATIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13974792",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "POLASKI",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.