NPIMap

Individual provider Active NPI

Lisa M Mazeika, PA-C

  • Physician Assistant
  • Hilton Head Island, SC
National Provider Identifier
1982658662
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
BLC1791174 Issued in SC
Practice address
460 William Hilton Pkwy
Hilton Head Island, SC 29926-2497
Phone
(843) 738-4800
Fax
(843) 738-4801
NPI assigned
May 19, 2006
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA001688L PA
Physician Assistant 363A00000X BLC1791174 SC Primary

Addresses

Primary practice location

460 William Hilton Pkwy
Hilton Head Island, SC 29926-2497

Mailing address

460 William Hilton Pkwy
Hilton Head Island, SC 29926-2497
Phone (843) 738-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110527000565 PA Practitioner - Physician Assistant 0345427324 Reassigns benefits to 1 organization
I20240314000604 SC Practitioner - Physician Assistant 0345427324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Symbios Medical ServicesGroup PAC ID 2860899200, 12 clinicians

Practice addresses (Care Compare)

460 William Hilton Pkwy
Hilton Head Island, SC 29926-2497
Phone (843) 738-4800

460 William Hilton Pkwy
Suite a
Hilton Head, SC 29926-2498

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA001688LPAMDPhysician Assistant
BLC1791174SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince May 26, 2015 Accepting new patients
Tower Health Medical Group CurrentSince May 26, 2015 Accepting new patients
Southern Berks Family Medicine, PC Past Accepting new patients

Locations

315 Darby Sq
Elverson, PA 19520
Phone (610) 898-5240

4885 Demoss Rd
Ste 201
Reading, PA 19606
Phone (610) 779-9489

495 W Ridge Pike
Royersford, PA 19468
Phone (610) 495-0400

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

950B N Wyomissing Blvd
Wyomissing, PA 19610
Phone (610) 898-1820

Interoperability endpoints

  • Direct secure messaging: lisa.mazeika.1@25915.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1982658662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 WILLIAM HILTON PKWY",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262497",
            "telephone_number": "843-738-4800",
            "fax_number": "843-738-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WILLIAM HILTON PKWY",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262497",
            "telephone_number": "843-738-4800",
            "fax_number": "843-738-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZEIKA",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA001688L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "BLC1791174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.