Individual provider Active NPI

Lisa A Korban, FNP, APNP

  • Primary Care Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1932193638
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2404-033 Issued in WI
Practice address
2350 N Lake Dr
Suite 400
Milwaukee, WI 53211-4528
Phone
(414) 271-1633
Fax
(414) 271-5071
NPI assigned
Sep 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2404-033 WI Primary

Addresses

Primary practice location

2350 N Lake Dr
Suite 400
Milwaukee, WI 53211-4528

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 271-1633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20041117000789 WI Practitioner - Nurse Practitioner 1557325776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 N Lake Dr
Milwaukee, WI 53211-4508

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000

2350 N Lake Dr
Milwaukee, WI 53211-4528

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2404-033WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Apr 24, 2012 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Apr 24, 2012 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients

Locations

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

13133 N Port Washington Rd
Ste 116
Mequon, WI 53097
Phone (262) 243-3700

13133 N Port Washington Rd
Mequon, WI 53097
Phone (262) 243-5850

2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000

3056 S Kinnickinnic Ave
Ste 300
Milwaukee, WI 53207
Phone (414) 294-0971

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 270-1633

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

10950 W Capitol Dr
Wauwatosa, WI 53222
Phone (414) 464-4460

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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.

Hospital & facility affiliations 1

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1932193638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-271-1633",
            "fax_number": "414-271-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-271-1633",
            "fax_number": "414-271-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBAN",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "FNP, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "2404-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.