NPIMap

Individual provider Active NPI

Sarah Elizabeth Carlisle, FNP-C

  • Nurse Practitioner
  • Canyon, TX
National Provider Identifier
1962010892
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1003517 Issued in TX
Practice address
1619 4TH Ave
Canyon, TX 79015-3824
Phone
(806) 557-4674
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1003517 TX Primary

Addresses

Primary practice location

1619 4TH Ave
Canyon, TX 79015-3824

Mailing address

1619 4TH Ave
Canyon, TX 79015-3824
Phone (806) 557-4674

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sarah.carlisle1@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119000161 TX Practitioner - Nurse Practitioner 8921419128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center Lubbock 363 clinicians

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-2757

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jun 14, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jun 14, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Cross Medical Clinic PLLC Family Past Accepting new patients

Locations

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Organizations & group practices 8

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 5

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1962010892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 4TH AVE",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790153824",
            "telephone_number": "806-557-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 4TH AVE",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790153824",
            "telephone_number": "806-557-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1003517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah.carlisle1@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canyon, TX

Sources for this page

Verify at the official NPI Registry.