NPIMap

Individual provider Active NPI

Lisa Marie Girasa

  • Psychologist
  • Portland, OR
National Provider Identifier
1922344076
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3125 Issued in WA
Practice address
3034 NE MLK Blvd
Portland, OR 97212-3053
Phone
(503) 889-2500
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 3125 WA Primary

Addresses

Primary practice location

3034 NE MLK Blvd
Portland, OR 97212-3053

Mailing address

PO Box 8459
Portland, OR 97207-8459
Phone (503) 238-0769

Other names 1

  • Lisa Marie Wineland Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200319002381 WA Practitioner - Clinical Psychologist 8426486796 Reassigns benefits to 1 organization
I20200320000948 OR Practitioner - Clinical Psychologist 8426486796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

2101 NE 139TH St
Suite 250
Vancouver, WA 98686-2309
Phone (360) 487-1717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3125WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Feb 1, 2020 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Feb 1, 2020 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Feb 1, 2020 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Feb 1, 2020 Accepting new patients
Cascadia Health Past Accepting new patients
Cascadia Health Past Accepting new patients

Locations

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

2101 NE 139th St
Ste 250
Vancouver, WA 98686
Phone (360) 487-1717

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1922344076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3034 NE MLK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123053",
            "telephone_number": "503-889-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRASA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "3125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WINELAND",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.