Individual provider Active NPI

Lisa Katherine Fasone, PA-C

  • Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1932743432
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121981 Issued in FL
Practice address
3450 11TH CT
Vero Beach, FL 32960-5012
Phone
(877) 463-2010
NPI assigned
Oct 29, 2019
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9121981 FL Primary

Addresses

Primary practice location

3450 11TH CT
Vero Beach, FL 32960-5012

Mailing address

3450 11TH CT
Vero Beach, FL 32960-5012
Phone (877) 463-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20191213001109 IL Practitioner - Physician Assistant 9436582962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

4309 W Medical Ctr Dr
Suite A201
McHenry, IL 60050-8411
Phone (815) 759-8070

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Nov 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 13, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 13, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince Nov 1, 2022 Accepting new patients
Saint Anthony Medical Center PastSince Nov 3, 2019 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1932743432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 11TH CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605012",
            "telephone_number": "877-463-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 11TH CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605012",
            "telephone_number": "877-463-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASONE",
        "first_name": "LISA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.