NPIMap

Individual provider Active NPI

Jeffrey J Lisko, MD

  • Gastroenterology Physician
  • Saint Paul, MN
National Provider Identifier
1861453771
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
41201 Issued in MN
Practice address
2550 University Ave W
Suite 423 South
Saint Paul, MN 55114-1052
Phone
(612) 870-5557
Fax
(612) 870-5857
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 41201 MN Primary

Addresses

Primary practice location

2550 University Ave W
Suite 423 South
Saint Paul, MN 55114-1052

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 870-5557

Other identifiers 1

IdentifierTypeStateIssuer
364818400MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlisko84775@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507000963 MN Practitioner - GastroenterologyPractitioner - Internal Medicine 4587653332 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

  • Buffalo Hospital Hospital, Buffalo, MN, CCN 240076
  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy88
Upper gastrointestinal (GI) endoscopy for acid reflux119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41201MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
St. Francis Regional Medical Center CurrentSince May 1, 2020 Accepting new patients
St Francis Regional Medical Center CurrentSince May 1, 2020 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 19, 2019 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Aug 19, 2019 Accepting new patients
Affiliated Endoscopy Centers, LLC Past Accepting new patients
Allina Health System Past Accepting new patients
Community Anesthesia Professionals PLLC PastSince Mar 1, 2016 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

303 Catlin St
Ste 10
Buffalo, MN 55313
Phone (763) 682-5225

303 Catlin St
Ste 100
Buffalo, MN 55313
Phone (763) 684-6160

303 Catlin St
Buffalo, MN 55313
Phone (763) 682-1212

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

1601 Saint Francis Ave
Ste 100
Shakopee, MN 55379
Phone (952) 403-3535

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jlisko84775@excellian.direct.allina.com

Organizations & group practices 10

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.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1861453771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909",
            "telephone_number": "612-870-5557",
            "fax_number": "612-870-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 423 SOUTH",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "612-870-5557",
            "fax_number": "612-870-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISKO",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "41201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364818400",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlisko84775@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2550 University Ave W",
            "address_2": "Suite 423 South",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551141052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.