Liisa Marie Travis, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95019345 Issued in CA

Practice address

12490 Business Center Dr Ste 100
Victorville, CA 92395-5833

Phone

(760) 552-8585

NPI assigned

Oct 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Orthopaedic Trauma Specialists PMCGroup PAC ID 4082992623, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300
• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• Community Hospital of San Bernardino Hospital, San Bernardino, CA, CCN 050089

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: liisa.travis.1@20474.direct.athenahealth.com

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.

• Premier Orthopaedic Trauma Specialists, PMC

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1407304439
  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• High Desert Neuro-Diagnostic Medical Group, Inc.

  • Specialist
  • Apple Valley, CA
  • NPI 1922028539
  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment NPD
• Sports Medicine and Orthopaedic Institute

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Victorville, CA
  • NPI 1669993218
  Medicare reassignment NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Body Imaging Physician
  • Rialto, CA
  • NPI 1700495363
  NPD

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

• Community Hospital of San Bernardino

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1235290818
  Care Compare affiliation
• Desert Valley Hospital, LLC

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  Care Compare affiliation
• St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186
  Care Compare affiliation

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1780346072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100B BEAR VALLEY RD # 283",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955851",
            "telephone_number": "209-499-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12490 BUSINESS CENTER DR STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955833",
            "telephone_number": "760-552-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "French Camp",
            "state": "CA",
            "postal_code": "952319693",
            "country_code": "US",
            "telephone_number": "209-468-6000 x7417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "LIISA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019345",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "494033",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "494033",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "494033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltravis@sjgh.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 W Hospital Rd",
            "city": "French Camp",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952319693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltravis@sjgh.org",
            "affiliation": "N",
            "endpointDescription": "hospital email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 W Hospital Rd",
            "city": "French Camp",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952319693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jennifer Tran
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• Tiffany T. Tran, MD
• Transport4Us LLC
• Tree of Life Counseling, a Licensed Clinical Social Worker Corporation
• Beatriz Trejo
• Jamie Trejo
• Caitlin Gabrielle Tremblay
• Celine Trieu

• Nurse Practitioner in Victorville, CA
• Providers in Victorville, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2023; 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.