Lisa Annette O'Brien, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003345 Issued in MI

Practice address

1215 East Michigan Avenue
Sparrow Hospital, Division of Neonatology
Lansing, MI 48912

Phone

(517) 364-2670

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1962873042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "STE A109F",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EAST MICHIGAN AVENUE",
            "address_2": "SPARROW HOSPITAL, DIVISION OF NEONATOLOGY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-364-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "LISA",
        "middle_name": "ANNETTE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Nicole Nyberg
• Henry Carl Nygren, M.D.
• Michael Nykamp, DDS
• Heather Nystrom, LMSW
• Corey Michael O'Brien, D.O.
• Mallory Elaine O'Brien, PA-C
• Miranda O'Brien, LLMSW
• Audrey O'Connor, DO
• Michael Patrick O'Connor, OTR, CAPS, CBIST
• Danyelle O'Dell, MD

• Physician Assistant in Lansing, MI
• Providers in Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.