Individual provider Active NPI

Steffen Lis, MD

  • Internal Medicine Physician
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1790241933
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2023-1095 Issued in NM
Practice address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone
(210) 916-2153
Fax
(210) 916-0709
NPI assigned
Feb 12, 2019
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD2023-1095 NM Primary
General Practice Physician 208D00000X 74929-20 WI

Addresses

Primary practice location

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-2153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20240129000157 NM Practitioner - Internal Medicine 3779987540 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Medicine Physicians LLC Internal Medicine CurrentSince Dec 10, 2023 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1790241933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-2153",
            "fax_number": "210-916-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-2153",
            "fax_number": "210-916-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS",
        "first_name": "STEFFEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2023-1095",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "74929-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.