Lisvan Carrero Fernandez Sr.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0101642 Issued in MD

Practice address

10205 Baltimore Ave Apt 7206
College Park, MD 20740-4244

Phone

(786) 659-7896

NPI assigned

Apr 14, 2022

Last updated

Dec 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, shared by 26 NPIs, 258 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdexchange@patientfirstclinics.com

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.

• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Silver Spring, MD
  • NPI 1265866503

  DC

  Medicare reassignment NPD
• Patient First Maryland Medical Group, PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1962423632

  MD

  Medicare reassignment NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Waldorf, MD
  • NPI 1205087517
  NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Capitol Heights, MD
  • NPI 1427807999
  NPD

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1932842432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10205 BALTIMORE AVE APT 7206",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207404244",
            "telephone_number": "786-659-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10205 BALTIMORE AVE APT 7206",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207404244",
            "telephone_number": "786-659-7896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Cedar Ln",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210443635",
            "country_code": "US",
            "telephone_number": "443-718-4067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRERO FERNANDEZ",
        "first_name": "LISVAN",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-14",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0101642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5900 Cedar Ln",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prisco Chapajong

• Internal Medicine Physician in College Park, MD
• Providers in College Park, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.