Active NPI
Lisa B. Vanwagner, M.D.
- Gastroenterology Physician
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- T5230
- Practice address
- 6201 Harry Hines Blvd
Dallas, TX 75390-3111 - Phone
- (214) 633-5555
- NPI assigned
- Mar 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Transplant Hepatology Physician | 207RT0003X | 036124551 | IL | |
| Gastroenterology Physician | 207RG0100X | 036124551 | IL | |
| Hepatology Physician | 207RI0008X | T5230 | TX | |
| Hepatology Physician | 207RI0008X | 036124551 | IL | |
| Transplant Hepatology Physician | 207RT0003X | T5230 | TX | |
| Gastroenterology Physician | 207RG0100X | T5230 | TX | Primary |
Addresses
Primary practice location
6201 Harry Hines Blvd
Dallas, TX 75390-3111
Mailing address
PO Box 845347
Dallas, TX 75284-7208
Phone (214) 645-6284
Other names 1
- Miss Lisa Beth Sandstrom
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- University of Virginia School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone (214) 633-5555
Hospital & facility affiliations
- Ut of Texas Southwestern University Hospital - William P. Clements Jr.
- Texas Health Presbyterian Hospital Dallas
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.87 of 100
- Quality
- 70.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.75
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 14 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036124551 | IL | MD | Transplant Hepatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Hepatology | Current | Accepting new patients |
Locations
2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563
5939 Harry Hines Blvd
Ste 700
Dallas, TX 75235
Phone (214) 645-1919
6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700
3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591
5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1760452767
Hepatology
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1396779948
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1285798918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658102400000",
"number": "1881865640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845347",
"city": "DALLAS",
"state": "TX",
"postal_code": "752847208",
"telephone_number": "214-645-6284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753903111",
"telephone_number": "214-633-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANWAGNER",
"first_name": "LISA",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2022-07-18",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RT0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Transplant Hepatology",
"state": "IL",
"license": "036124551",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036124551",
"primary": false
},
{
"code": "207RI0008X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hepatology",
"state": "TX",
"license": "T5230",
"primary": false
},
{
"code": "207RI0008X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hepatology",
"state": "IL",
"license": "036124551",
"primary": false
},
{
"code": "207RT0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Transplant Hepatology",
"state": "TX",
"license": "T5230",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "T5230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "SANDSTROM",
"middle_name": "BETH",
"prefix": "MISS",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.