Individual provider Active NPI

Lisa Marie Littlejohn, PA-C

  • Physician Assistant
  • Pittston, PA
National Provider Identifier
1891121562
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063256 Issued in PA
Practice address
42 N Main St
Pittston, PA 18640-1916
Phone
(570) 602-5610
Fax
(570) 602-5611
NPI assigned
Sep 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017030 NY
Physician Assistant 363A00000X MA063256 PA Primary

Addresses

Primary practice location

42 N Main St
Pittston, PA 18640-1916

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Ms. Lisa Marie Decicco Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220602002239 PA Practitioner - Physician Assistant 0446638415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1201 Oak St
Pittston, PA 18640-3798
Phone (570) 808-9800

5 Lakeview Dr
Moosic, PA 18507-2108
Phone (570) 558-2180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017030NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Jun 6, 2022 Accepting new patients
Geisinger Clinic CurrentSince Jun 6, 2022 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

1020 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2290

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

10 Trieble Dr
Tunkhannock, PA 18657
Phone (570) 836-2273

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

Interoperability endpoints

  • Direct secure messaging: llittlejohn497033@direct.geisinger.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1891121562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401916",
            "telephone_number": "570-602-5610",
            "fax_number": "570-602-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEJOHN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017030",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DECICCO",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittston, PA

Sources for this page

Verify at the official NPI Registry.