Individual provider Active NPI

Jessica Marie Lizio, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1871233007
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MPA.4265 Issued in SC
Practice address
10203 High Peak Dr
Greenville, SC 29609-1257
Phone
(631) 905-8655
NPI assigned
Mar 29, 2022
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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 MPA.4265 SC Primary

Addresses

Primary practice location

10203 High Peak Dr
Greenville, SC 29609-1257

Mailing address

10203 High Peak Dr
Greenville, SC 29609-1257
Phone (631) 905-8655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629003914 SC Practitioner - Physician Assistant 8628458122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

101 E Wood St
Spartanburg, SC 29303-3040

225 E Wood St
Spartanburg, SC 29303-3050
Phone (864) 583-4420

853 N Church St
Suite 410a
Spartanburg, SC 29303-3098
Phone (864) 560-6928

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4265SCMDSpeech-Language Pathologist
MPA.4265SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Spartanburg Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

225 E Wood St
Spartanburg, SC 29303
Phone (864) 560-4420

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

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 4

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1871233007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203 HIGH PEAK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296091257",
            "telephone_number": "631-905-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10203 HIGH PEAK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296091257",
            "telephone_number": "631-905-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZIO",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "MPA.4265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.