Active NPI
Lisa Baeza Johnson, MD
- Child & Adolescent Psychiatry Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD2018-0781
- Practice address
- 8300 Constitution Ave NE
Albuquerque, NM 87110 - Phone
- (505) 291-2500
- NPI assigned
- Aug 31, 2006
- Last updated
- Sep 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | T2002014678 | MO | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD2018-0781 | NM | Primary |
Addresses
Primary practice location
8300 Constitution Ave NE
Albuquerque, NM 87110
Mailing address
PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770
Other practice location 1
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000
Other practice location 2
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Phone (505) 454-2842
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T2002014678 | MO | MD | Psychiatry Physician |
| MD2018-0781 | NM | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New Mexico | Current | Accepting new patients |
Locations
3695 Hot Springs Blvd
Las Vegas, NM 87701
Phone (505) 454-2100
Interoperability endpoints
- lisa.johnsonmd.p1@direct.tgcaz.nextgenshare.com
Organizations & group practices 2
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.
-
dba NM Behavioral Health Institute at Las Vegas
- Nursing Facility/Intermediate Care Facility
- Las Vegas, NM
- NPI 1992867998
-
dba New Mexico Behavioral Health Institue at Las Vegas
- Clinical Medical Laboratory
- Las Vegas, NM
- NPI 1407057607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538092800000",
"number": "1962514349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26666",
"address_2": "PHS PROVIDER ENROLLMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256666",
"telephone_number": "505-923-6770",
"fax_number": "505-923-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 CONSTITUTION AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87110",
"telephone_number": "505-291-2500"
}
],
"practiceLocations": [
{
"address_1": "1300 E Bradford Pkwy",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "MO",
"postal_code": "658044264",
"country_code": "US",
"telephone_number": "417-761-5000",
"fax_number": "417-761-5011",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1300 E Bradford Pkwy",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "MO",
"postal_code": "658044264",
"country_code": "US",
"telephone_number": "417-761-5000",
"fax_number": "417-761-5011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "LISA",
"middle_name": "BAEZA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2018-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "T2002014678",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NM",
"license": "MD2018-0781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.