NPIMap

Individual provider Active NPI

Lisa Meza, P.A.-C

  • Physician Assistant
  • Watersmeet, MI
National Provider Identifier
1811363690
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007437 Issued in MI
Practice address
E23970 Pow Wow Trail
Watersmeet, MI 49969
Phone
(906) 358-4587
Fax
(906) 358-4118
NPI assigned
Aug 17, 2015
Last updated
Aug 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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 5601007437 MI Primary

Addresses

Primary practice location

E23970 Pow Wow Trail
Watersmeet, MI 49969

Mailing address

E23970 Pow Wow Trail
Watersmeet, MI 49969
Phone (906) 358-4587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160112000905 TX Practitioner - Physician Assistant 0840592119 Reassigns benefits to 1 organization
I20240513002433 WI Practitioner - Physician Assistant 0840592119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1660 Sue Alan Dr
Wittenberg, WI 54499-8655
Phone (715) 253-2110

2251 N Shore Dr
Rhinelander, WI 54501-6710

240 Maple St
Woodruff, WI 54568-9190
Phone (715) 356-8140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

Interoperability endpoints

  • Direct secure messaging: lmeza219416@direct.aspirus.org

Organizations & group practices 3

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.

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1811363690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E23970 POW WOW TRAIL",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "49969",
            "telephone_number": "906-358-4587",
            "fax_number": "906-358-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E23970 POW WOW TRAIL",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "49969",
            "telephone_number": "906-358-4587",
            "fax_number": "906-358-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZA",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watersmeet, MI

Sources for this page

Verify at the official NPI Registry.