Edward J Lis Jr., D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

5101014456 Issued in MI

Practice address

6310 Sashabaw Rd
Suite a
Clarkston, MI 48346-2270

Phone

(248) 620-2325

Fax

(248) 620-2326

NPI assigned

Jan 26, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Orthopedic Surgery

Education

Midwestern University, Chicago College of Osteopathic Med, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suncare Home Health Home health agency, Shelby Township, MI, CCN 239191
• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197
• Hurley Medical Center Hospital, Flint, MI, CCN 230132

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.lis.1@15740.direct.athenahealth.com
• Direct secure messaging: elis1139339@direct.hfhs.org
• FHIR API: https://api.platform.athenahealth.com/15740/brand/1/csg/1/fhir/r4

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.

• Hurley Medical Center

  dba Hurley OB/GYN Research & Education

  • Obstetrics & Gynecology Physician
  • Flint, MI
  • NPI 1982630844
  Medicare reassignment Care Compare group NPD
• Edward J. Lis, Jr, DO, PLLC

  • Orthopaedic Surgery Physician
  • Fenton, MI
  • NPI 1578086146
  Medicare reassignment NPD
• Hurley Medical Center

  dba Hurley Orthopedic Research & Education

  • Orthopaedic Surgery Physician
  • Flint, MI
  • NPI 1346289196
  NPD
• Hurley Medical Center

  • Plastic and Reconstructive Surgery Physician
  • Flint, MI
  • NPI 1689345761
  NPD
• Hurley Medical Center

  dba Hurley Internal Medicine Research & Education

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1427092998
  NPD (past)
• Pontiac General Hospital and Medical Centers

  dba North Oakland Medical Centers

  • Family Medicine Physician
  • Pontiac, MI
  • NPI 1265585871
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Healthstar Home Care, Inc

  dba Suncare Home Health, Inc.

  • Home Health Agency
  • Shelby Township, MI
  • NPI 1457584252
  Care Compare affiliation
• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation
• Hurley Medical Center

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1598717480
  Care Compare affiliation

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952371338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 SASHABAW RD",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462270",
            "telephone_number": "248-620-2325",
            "fax_number": "248-620-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 SASHABAW RD",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462270",
            "telephone_number": "248-620-2325",
            "fax_number": "248-620-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101014456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4623098",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lifepointe Chiro PLLC
• Lifepointe Chiropractic Center, PLC
• Ashley Liggett, MS, BCBA, LBA
• Marcia E Lillis, BSN, RN
• Charles Genghis Line, MD
• Lisa Dietz DO PLLC
• Dana Sue Litheland, MA TLLP
• Bryaunte Safiyyah Little
• Dawn Littleton
• Live Well Fitness and Physical Therapy

• Orthopaedic Surgery Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.