Active NPI
Lisa M Vivian, PA
- Physician Assistant
- Brookville, PA
National Provider Identifier
1942520085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA054395
- Practice address
- 22 Industrial Park Rd
Brookville, PA 15825-7228 - Phone
- (814) 849-0990
- Fax
- (814) 849-0992
- NPI assigned
- Jun 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA054395 | PA | Primary |
Addresses
Primary practice location
22 Industrial Park Rd
Brookville, PA 15825-7228
Mailing address
100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-0990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03253321 | Medicaid | NY |
Other names 1
- Lisa M Himes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 371-2200
1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-5585
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.42 of 100
- Quality
- 75.58
- Improvement activities
- 40
- Cost
- 72.74
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group of Pennsylvania PC | Current | Accepting new patients | |
| Dubois Regional Medical Center | Physician Assistant | Past | Accepting new patients |
Locations
100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408
809 Turnpike Ave
Clearfield, PA 16830
Phone (814) 765-5341
100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Scottsdale, AZ
- NPI 1568633535
PA
-
- General Acute Care Hospital
- Du Bois, PA
- NPI 1144249657
Physician Assistant
Hospital & facility affiliations 33
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Brookville, PA
- NPI 1760452924
-
- Maternal & Fetal Medicine Physician
- Du Bois, PA
- NPI 1033213608
Hospital
-
- General Acute Care Hospital
- Du Bois, PA
- NPI 1144249657
-
- Endocrinology, Diabetes & Metabolism Physician
- Du Bois, PA
- NPI 1245341387
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384214400000",
"number": "1942520085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL RD",
"city": "BROOKVILLE",
"state": "PA",
"postal_code": "158251367",
"telephone_number": "814-849-0990",
"fax_number": "814-849-0992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 INDUSTRIAL PARK RD",
"city": "BROOKVILLE",
"state": "PA",
"postal_code": "158257228",
"telephone_number": "814-849-0990",
"fax_number": "814-849-0992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVIAN",
"first_name": "LISA",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-10",
"last_updated": "2013-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA054395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03253321",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "HIMES",
"middle_name": "M",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Brookville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.