Lisa Lovas Bakhos, MD
Individual provider Active NPI Pediatrics Physician · Providence, RI
NPI 1902932767 · NPPES record last updated Feb 5, 2010
Key facts
- NPI
- 1902932767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD12383 (RI)
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 519-1604
- Fax
- (401) 272-0538
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101209001383 | NJ | Practitioner - Emergency Medicine |
8527141241 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-221687 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brown Emergency Medicine | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | L-221687 | MA | |
| Pediatrics Physician | 208000000X | MD12383 | RI | Yes |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
PO Box 9484
Providence, RI 02940-9484
Phone (401) 854-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07282008 | Other | RI | BCBSRI |
| 12/29/2008 | Other | MA | TUFTS HEALTH PLAN |
| 12292008 | Other | RI | TUFTS |
| LB69118 | Medicaid | RI | |
| 04/15/2009 | Other | RI | UNITED HEALTHCARE |
| 007059893 | Other | RI | MEDICARE |
| 1962455022 | Other | RI | UEMF GROUP NPI |
| 1902932767 | Other | RI | NPI |
| 2146533 | Other | MA | MA MEDICAID |
| 939025129 | Other | RI | UEMF GROUP RI MEDICARE |
Other names
- Dr. Lisa Lovas
Other providers in Providence, RI
- Elizabeth P Baker
- Lindsay E Baker
- Paul Baker
- Shera Baker
- Sherriah Baker
- Lauren Bakios
- Jennifer Bender Bakkensen
- Rupa Bala
- Balance Chiropractic & Wellness Center, P.C.
- Amanda Baldaro
All providers in Providence, RI · Pediatrics Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.