Individual provider Active NPI

Leisa Sierra Lord-Halvorson

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1942778394
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7730 Issued in MA
Practice address
450 Brookline Ave
Boston, MA 02215-5450
Phone
(617) 632-3000
Fax
(617) 582-6021
NPI assigned
Nov 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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 PA7730 MA Primary

Addresses

Primary practice location

450 Brookline Ave
Boston, MA 02215-5450

Mailing address

450 Brookline Ave
Boston, MA 02215-5450

Other practice location 1

157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-6700

Other practice location 2

55 Lake Ave N
Worcester, MA 01655-0001
Phone (508) 334-3550

Other identifiers 1

IdentifierTypeStateIssuer
110164413AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address llordhalvorson339737@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191120001511 NY Practitioner - Physician Assistant 8426480005 Reassigns benefits to 1 organization
I20201117000385 MA Practitioner - Physician Assistant 8426480005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

155 Union St
Marlborough, MA 01752-1228
Phone (508) 481-7390

157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-5521

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3000

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
65.04
Promoting interoperability
100
Improvement activities
40
Cost
69.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Oct 1, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Oct 7, 2019 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
Ste 255
New Hyde Park, NY 11040
Phone (718) 470-3000

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: llordhalvorson339737@umassmemorial.direct-ci.com
  • Direct secure messaging: lord-halvorson.leisa.bwh@direct.partners.masshiway.net

Organizations & group practices 7

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": "1541289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1942778394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155450",
            "telephone_number": "617-632-3000",
            "fax_number": "617-582-6021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017521228",
            "country_code": "US",
            "telephone_number": "508-486-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550001",
            "country_code": "US",
            "telephone_number": "508-334-3550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORD-HALVORSON",
        "first_name": "LEISA",
        "middle_name": "SIERRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-04",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110164413A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llordhalvorson339737@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.