Active NPI
Lisa A. Flatley, PA-C
- Physician Assistant
- Ridgewood, NJ
National Provider Identifier
1790177053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MP427
- Practice address
- 1200 E Ridgewood Ave Ste 200
Ridgewood, NJ 07450-3937 - Phone
- (908) 522-2000
- NPI assigned
- Feb 24, 2015
- Last updated
- Nov 1, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MP427 | NJ | Primary |
Addresses
Primary practice location
1200 E Ridgewood Ave Ste 200
Ridgewood, NJ 07450-3937
Mailing address
1805 Hidden Pond LN
Toms River, NJ 08755-1354
Phone (732) 349-6339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MP427 | NJ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477958400000",
"number": "1790177053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 HIDDEN POND LN",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087551354",
"telephone_number": "732-349-6339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 E RIDGEWOOD AVE STE 200",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503937",
"telephone_number": "908-522-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLATLEY",
"first_name": "LISA",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-24",
"last_updated": "2016-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "MP427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.