Individual provider Active NPI

Jerome P Lisk, MD, MBA

  • Neurology Physician
  • Denton, TX
National Provider Identifier
1821036500
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
R1074 Issued in TX
Practice address
3537 S I 35 E Ste 112
Denton, TX 76210-6868
Phone
(940) 383-1770
Fax
(833) 992-0840
NPI assigned
Jun 3, 2006
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X R1074 TX Primary
Neurology Physician 2084N0400X 2004029825 MO
Neurology Physician 2084N0400X A88331 CA

Addresses

Primary practice location

3537 S I 35 E Ste 112
Denton, TX 76210-6868

Mailing address

3537 S I 35 E Ste 112
Denton, TX 76210-6868
Phone (940) 383-1770

Other identifiers 5

IdentifierTypeStateIssuer
P01773741OtherTXRAIL ROAD MEDICARE
366511901MedicaidTX
P00890011OtherCAMEDICARE RAILROAD
207238106MedicaidMO
193247OtherBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080205000358 CA Practitioner - Neurology 4082667159 Reassigns benefits to 1 organization
I20170109001582 TX Practitioner - Neurology 4082667159 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Virginia Commonwealth University, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15243 Vanowen St
Suite 205
Van Nuys, CA 91405-3640
Phone (760) 618-9285

3537 S I 35
Suite 112
Denton, TX 76210-6868
Phone (940) 383-1770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A88331CAMDNeurology Physician
R1074TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Dec 16, 2016 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 16, 2016 Accepting new patients
Talis Healthcare LLC CurrentSince Jul 1, 2022 Accepting new patients
Ferrell Duncan Clinic, Inc Past Accepting new patients

Locations

3120 Medpark Dr
Ste 100
Denton, TX 76208
Phone (214) 432-7549

7227 Fannin St
Ste 101
Houston, TX 77030
Phone 84477677789

7501 Fannin St
Ste 900A
Houston, TX 77054
Phone (321) 888-2523

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

910 E Houston St
Ste 330
Tyler, TX 75702
Phone (903) 510-8718

Interoperability endpoints

  • Direct secure messaging: jerome.lisk.1@22955.direct.athenahealth.com
  • Direct secure messaging: jlisk140047@christushealth.direct-ci.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1821036500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 S I 35 E STE 112",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106868",
            "telephone_number": "940-383-1770",
            "fax_number": "833-992-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 S I 35 E STE 112",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106868",
            "telephone_number": "940-383-1770",
            "fax_number": "833-992-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISK",
        "first_name": "JEROME",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "R1074",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2004029825",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A88331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01773741",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366511901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00890011",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207238106",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "193247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.