NPIMap

Individual provider Active NPI

Lisa Marie Carbonell, MD

  • Obstetrics & Gynecology Physician
  • Ventura, CA
National Provider Identifier
1861780215
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A138425 Issued in CA
Practice address
120 N Ashwood Ave
Ventura, CA 93003-1810
Phone
(805) 658-5800
Fax
(805) 642-1928
NPI assigned
Jul 19, 2011
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A138425 CA Primary

Addresses

Primary practice location

120 N Ashwood Ave
Ventura, CA 93003-1810

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151120002556 CA Practitioner - Obstetrics/Gynecology 6507166600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Puerto Rico School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

120 N Ashwood Ave
Ventura, CA 93003-1810
Phone (805) 658-5800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138425CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Mar 1, 2018 Accepting new patients
Tahoe Carson Valley Medical Group Inc Obstetrics & Gynecology CurrentSince Nov 2, 2015 Accepting new patients
Community Memorial Health System CurrentSince Mar 1, 2018 Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2361 E Vineyard Ave
Oxnard, CA 93036
Phone (805) 981-3770

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5659

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

2175 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5711

120 N Ashwood Ave
Ventura, CA 93003
Phone (805) 658-5800

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lcarbonell3509246@oc.providencedirect.org
  • Direct secure messaging: lisacarbonell@cfh.allscriptsdirect.net

Organizations & group practices 4

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 10

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1861780215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N ASHWOOD AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031810",
            "telephone_number": "805-658-5800",
            "fax_number": "805-642-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONELL",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A138425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.