Individual provider Active NPI

Lisa Jeanne Sanders, MD

  • Pediatric Infectious Diseases Physician
  • Tampa, FL
National Provider Identifier
1881162402
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
ME53030 Issued in FL
Practice address
1315 E 7TH Ave Ste 104
Tampa, FL 33605-3606
Phone
(813) 396-9021
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 53030 FL
Pediatric Infectious Diseases Physician 2080P0208X ME53030 FL Primary

Addresses

Primary practice location

1315 E 7TH Ave Ste 104
Tampa, FL 33605-3606

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201

Other practice location 1

2 Tampa General Cir
Tampa, FL 33606-3603
Phone (813) 974-2201

Other identifiers 3

IdentifierTypeStateIssuer
107818200MedicaidFL
MY949OtherFLMEDICARE
18532OtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Lisa Jeanne Istorico Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsanders176120@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200831000567 FL Practitioner - Infectious Disease 9234556671 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53030FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Aug 25, 2020 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Aug 25, 2020 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

12901 N 30th St
Tampa, FL 33612
Phone (813) 974-0703

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lsanders176120@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1881162402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 E 7TH AVE STE 104",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336053606",
            "telephone_number": "813-396-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063603",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-2812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "LISA",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "53030",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "FL",
            "license": "ME53030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107818200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MY949",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "18532",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsanders176120@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ISTORICO",
            "middle_name": "JEANNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.