Active NPI
Lisa Sue Kaplan Distasio, RN
- Registered Nurse
- Danvers, MA
National Provider Identifier
1891810644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 215515
- Practice address
- 9 Post Gate Road
Danvers, MA 01923-1840 - Phone
- (978) 762-0669
- NPI assigned
- Mar 20, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 215515 | MA | Primary |
Addresses
Primary practice location
9 Post Gate Road
Danvers, MA 01923-1840
Mailing address
9 Post Gate Road
Danvers, MA 01923-1840
Phone (978) 762-0669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215515 | MA | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891810644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 POST GATE ROAD",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231840",
"telephone_number": "978-762-0669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 POST GATE ROAD",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231840",
"telephone_number": "978-762-0669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAPLAN DISTASIO",
"first_name": "LISA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "215515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.