Lisa Corstvet MD PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

16541 Issued in OK

Legal business name

LISA CORSTVET MD PLLC

Practice address

4317 W Memorial Rd
Oklahoma City, OK 73134-1720

Phone

(405) 418-4800

Fax

(405) 418-4820

NPI assigned

Sep 3, 2009

Last updated

Oct 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheri Moore

Title

Credentialing Coordinator

Phone

(405) 418-4800

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Margaret Corstvet, MD

  • Anesthesiology Physician
  • Oklahoma City, OK
  • NPI 1083628044
  Medicare reassignment

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1902039241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 975008",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753975008",
            "telephone_number": "405-418-4800",
            "fax_number": "405-418-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341720",
            "telephone_number": "405-418-4800",
            "fax_number": "405-418-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA CORSTVET MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "405-418-4800"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "16541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "614474300",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200257060A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Dawn Lipscomb, AANP, APRN, NP-C
• Francis Edward Lipsinic, D.D.S.
• Marlinda N Lira
• Yaritza Liriano, IDMT
• Lisa Corstvet MD PC
• Lisa D Taylor MD PC
• Lisa J Wasemiller-Smith MD Inc
• Lisa M Farhood MD PLLC
• Winifred Pauline Lisle, CNM
• Kyla Lister

• Anesthesiology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.