Individual provider Active NPI

Lishan Jhanealle Walker, MD

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1942613344
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
289449 Issued in NY
Practice address
10 S Pointe LNDG Ste 250
Rochester, NY 14606-3483
Phone
(585) 426-4084
Fax
(585) 723-0555
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 289449 NY Primary

Addresses

Primary practice location

10 S Pointe LNDG Ste 250
Rochester, NY 14606-3483

Mailing address

10 S Pointe LNDG Ste 250
Rochester, NY 14606-3483
Phone (585) 426-4084

Other identifiers 1

IdentifierTypeStateIssuer
04804317MedicaidNY

Other names 1

  • Miss Lishan Jhanealle Jackson Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lwalker117475@direct.urmc.rochester.edu Direct
Direct Messaging Address lwalker117475@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170908001007 NY Practitioner - Family Practice 0749592657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

10 S Pointe LNDG
Rochester, NY 14606-3481
Phone (585) 426-4084

2400 Clinton S Ave F
Rochester, NY 14618-2668
Phone (585) 244-7200

2400 Clinton S Ave G
Rochester, NY 14618-2668
Phone (585) 341-7685

2400 Clinton S Ave H
Rochester, NY 14618-2668
Phone (585) 341-7143

2400 S Clinton Ave
BLDG H
Rochester, NY 14618-2668
Phone (585) 341-7200

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jun 1, 2020 Accepting new patients
University of Rochester CurrentSince Jun 1, 2020 Accepting new patients
Highland Hospital of Rochester CurrentSince Aug 14, 2017 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients
Highland Hospital of Rochester Family Medicine CurrentSince Aug 14, 2017 Accepting new patients
University of Rochester Past Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

601 Elmwood Ave
#320
Rochester, NY 14642

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

10 S Pointe Lndg
Ste 250
Rochester, NY 14606
Phone (585) 225-5767

10 S Pointe Lndg
Ste 210
Rochester, NY 14606
Phone (585) 723-3330

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

Organizations & group practices 6

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 2

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1942613344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S POINTE LNDG STE 250",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146063483",
            "telephone_number": "585-426-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S POINTE LNDG STE 250",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146063483",
            "telephone_number": "585-426-4084",
            "fax_number": "585-723-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LISHAN",
        "middle_name": "JHANEALLE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "289449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04804317",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwalker117475@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwalker117475@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISHAN",
            "last_name": "JACKSON",
            "middle_name": "JHANEALLE",
            "prefix": "MISS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.