Lisa A. Rensberger, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004503 Issued in WA

Practice address

751 NE Blakely Dr Ste 3020
Issaquah, WA 98029

Phone

(425) 313-5345

Fax

(425) 313-4704

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lrensberger1043048@wm.providencedirect.org

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.

• Public Hospital Dist No 1 Skagit

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment
• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment
• Public Hospital Dist No 1 Skagit

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Virginia Mason Medical Center

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1730237942
  NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD
• Digestive Health Specialists PS

  • Gastroenterology Physician
  • Kent, WA
  • NPI 1710149802
  NPD (past)
• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401

  Physician Assistant

  NPD (past)
• Western Washington Endoscopy Centers LLC

  • Ambulatory Surgical Clinic/Center
  • Puyallup, WA
  • NPI 1982853271
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1841243383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR STE 3020",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98029",
            "telephone_number": "425-313-5345",
            "fax_number": "425-313-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENSBERGER",
        "first_name": "LISA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004503",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "5366RE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8450686",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC #",
            "identifier": "P00396760",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lrensberger1043048@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "751 NE Blakely Dr Ste 3020",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Ann Reich, MSW
• Nadene Reichert, MFT-A
• Kapitolina Reid, MD
• Patrick Beau Reilly, PH.D.
• Aislinn Tercie-Jeness Rennison, DACM
• Resilient Connections, PLLC
• Violet S Resnick, LICSW
• Revere Home Care
• Revive Physical Therapy
• Anthony Kain Reyes

• Physician Assistant in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.