Individual provider Active NPI

Lisa Stevens, PA-C

  • Physician Assistant
  • Springfield, OR
National Provider Identifier
1811207913
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA152783 Issued in OR
Practice address
2400 Hartman LN
Springfield, OR 97477-1118
Phone
(541) 334-3350
Fax
(541) 284-5198
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA152783 OR Primary

Addresses

Primary practice location

2400 Hartman LN
Springfield, OR 97477-1118

Mailing address

330 S Garden Way
Ste 390
Eugene, OR 97401-8179
Phone (541) 334-3350

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101103000740 OR Practitioner - Physician Assistant 9436343480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emerald Sleep Disorders Center LLCGroup PAC ID 2567435639, 5 clinicians

Practice addresses (Care Compare)

330 S Garden Way
Suite 390
Eugene, OR 97401-8179
Phone (541) 683-3325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA152783ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Sleep Disorders Center, LLC CurrentSince Sep 1, 2016 Accepting new patients

Locations

330 S Garden Way
Ste 390
Eugene, OR 97401
Phone (541) 683-1796

Interoperability endpoints

  • Direct secure messaging: emeraldsleepdisordercenter.lisastevens@114323.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1811207913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY",
            "address_2": "STE 390",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018179",
            "telephone_number": "541-334-3350",
            "fax_number": "541-284-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARTMAN LN",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771118",
            "telephone_number": "541-334-3350",
            "fax_number": "541-284-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "LISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA152783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.