NPIMap

Individual provider Active NPI

Lisa N Neavyn, M.D.

  • Ophthalmology Physician
  • Portland, ME
National Provider Identifier
1780812735
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD24235 Issued in ME
Practice address
15 Lowell St
Portland, ME 04102-2792
Phone
(207) 774-8277
Fax
(207) 523-5310
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 253205 MA
Ophthalmology Physician 207W00000X MD24235 ME Primary
Ophthalmology Physician 207W00000X 4301094262 MI

Addresses

Primary practice location

15 Lowell St
Portland, ME 04102-2792

Mailing address

15 Lowell St
Portland, ME 04102-2792
Phone (207) 774-8277

Other practice location 1

20 Southbridge Rd
Charlton, MA 01507-5235
Phone (508) 765-9068

Other practice location 2

591 Lincoln St
Worcester, MA 01605
Phone (508) 853-2020

Other names 1

  • Lisa Nicole Fredian Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20210402000123 ME Practitioner - Ophthalmology 8729230495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maine Eye Center PAGroup PAC ID 0446240634, 19 clinicians

Practice addresses (Care Compare)

15 Lowell St
Portland, ME 04102-2726
Phone (207) 774-8277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD24235MEMDOphthalmology Physician
4301094262MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Eye Center, PA CurrentSince Apr 21, 2021 Accepting new patients
Maine Eye Center, PA Current Accepting new patients
Maine Eye Center, PA Ophthalmology CurrentSince Apr 21, 2021 Accepting new patients
Umass Memorial Health-Harrington Hospital Inc Past Accepting new patients
Harrington Physician Services Inc Ophthalmology Past Accepting new patients

Locations

161 Marginal Way
Portland, ME 04101
Phone (207) 773-7964

15 Lowell St
Portland, ME 04102
Phone (207) 774-8277

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.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1780812735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022792",
            "telephone_number": "207-774-8277",
            "fax_number": "207-523-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022792",
            "telephone_number": "207-774-8277",
            "fax_number": "207-523-5310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Southbridge Rd",
            "address_purpose": "LOCATION",
            "city": "Charlton",
            "state": "MA",
            "postal_code": "015075235",
            "country_code": "US",
            "telephone_number": "508-765-9068",
            "fax_number": "508-765-0249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "591 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01605",
            "country_code": "US",
            "telephone_number": "508-853-2020",
            "fax_number": "508-853-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEAVYN",
        "first_name": "LISA",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "253205",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "MD24235",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301094262",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "FREDIAN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.