Individual provider Active NPI

Michele Lisi, M.D.

  • Diagnostic Radiology Physician
  • Syracuse, NY
National Provider Identifier
1952393589
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2277031 Issued in NY
Practice address
750 E Adams St
3Rd Floor Radiology
Syracuse, NY 13210-2306
Phone
(315) 464-6672
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 227703 NY
Diagnostic Radiology Physician 2085R0202X 2277031 NY Primary

Addresses

Primary practice location

750 E Adams St
3Rd Floor Radiology
Syracuse, NY 13210-2306

Mailing address

224 Harrison St
Suite 601
Syracuse, NY 13202-3056
Phone (315) 464-6672

Other identifiers 2

IdentifierTypeStateIssuer
02224500MedicaidNY
02375079MedicaidNY

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
I20040309001084 NY Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 3577451616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Radiology Associates, LLPGroup PAC ID 4981686110, 42 clinicians

Practice addresses (Care Compare)

208 Township Blvd
Suite 400
Camillus, NY 13031-1674
Phone (315) 551-6004

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-5526

550 Harrison St
Syracuse, NY 13202-3188

5584 E Main St
Suite F
Verona, NY 13478-3531
Phone (315) 473-3300

725 E Adams St
Syracuse, NY 13210-2576
Phone (315) 464-9057

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-5189

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Merit-based Incentive Payment System (MIPS)

Final score
91.49 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227703NYMDNuclear Medicine Physician
2277031NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Radiology Associates, LLP Diagnostic Radiology CurrentSince Jul 1, 2003 Accepting new patients
St. Josephs Imaging Associates PLLC Diagnostic Radiology Past Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Past Accepting new patients

Locations

208 Township Blvd
Ste 400
Camillus, NY 13031
Phone (315) 551-6004

8687 Carling Rd
Ste E
Liverpool, NY 13090
Phone (315) 473-3330

224 Harrison St
Ste 601
Syracuse, NY 13202
Phone (315) 464-6672

750 E Adams St
Fl 3
Syracuse, NY 13210
Phone (315) 464-6672

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

725 E Adams St
Ste 2A
Syracuse, NY 13210
Phone (315) 464-9057

4900 Broad Rd
Ste 2G
Syracuse, NY 13215
Phone (315) 299-5313

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: mlisi7232@direct.upstate.edu

Organizations & group practices 3

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 1

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1952393589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HARRISON ST",
            "address_2": "SUITE 601",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023056",
            "telephone_number": "315-464-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "address_2": "3RD FLOOR RADIOLOGY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISI",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NY",
            "license": "227703",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2277031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02224500",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02375079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.