Katherine Lisoni, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11011690 Issued in IN

Practice address

420 W 4TH St
Mishawaka, IN 46544-1948

Phone

(574) 307-7673

Fax

(574) 307-7692

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Family Practice

Education

Northwestern University Feinberg Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.lisoni@healthlinc.directbygreenway.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.

• Healthlinc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1528262581
  Medicare reassignment Care Compare group NPD
• Healthlinc, Inc

  • Federally Qualified Health Center (FQHC)
  • Morocco, IN
  • NPI 1568354116
  NPD
• Saint Joseph Community Hospital of Mishawaka

  • Multi-Specialty Clinic/Center
  • Mishawaka, IN
  • NPI 1235202573
  NPD (past)
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  NPD (past)
• Air Angels Inc

  • Air Ambulance
  • West Chicago, IL
  • NPI 1316949951
  NPD (past)

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

• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1780601351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 VALLEY DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832520",
            "telephone_number": "219-413-5100",
            "fax_number": "219-465-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "574-307-7673",
            "fax_number": "574-307-7692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1960 Northside Blvd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "46615",
            "country_code": "US",
            "telephone_number": "574-307-7673",
            "fax_number": "574-234-4706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISONI",
        "first_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11011690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200844990",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000580326",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katherine.lisoni@healthlinc.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "420 W 4th St",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465441948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey J Kintner
• Theodore J Lingenfelter, PHARMD
• Darla J Lingle, PT
• Russell Matthew Linman, DDS, MD
• Henry Linville
• Thomas Robert Litwicki Jr., BCBA
• Live Well Nutrition, Inc.
• Carolyn Logue, BS
• Kathleen Long, MD
• Kathleen A Long, APRN-BC, ND

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.