Lisan S Peng, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

40621 Issued in AZ

Practice address

3190 N Swan Rd
Tucson, AZ 85712-1227

Phone

(520) 547-9700

Fax

(520) 547-9719

NPI assigned

Jul 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Dermatology

Education

University of California, Geffen School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Community Physicians PCGroup PAC ID 4587560552, 162 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpeng17003@azacp.direct-ci.com

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.

• Arizona Community Physicians PC

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1205871076
  Medicare reassignment Care Compare group NPD
• Arizona Community Physician PC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Tucson, AZ
  • NPI 1922141902
  NPD

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1992969414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 E BROADWAY BLVD STE 251",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112700",
            "telephone_number": "520-327-0460",
            "fax_number": "520-795-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 N SWAN RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121227",
            "telephone_number": "520-547-9700",
            "fax_number": "520-547-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "LISAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "40621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z214203",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "355571",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Penczar, M.ED, LPC, MFT
• Anita Narayanan Pender, M.D.
• Deidre A Pender, OTR/L
• Tikeisha Danielle Pendleton, LMSW
• Annie Yu-Huey Peng, DO
• Athira Penghat, DO
• Jessie-Anne Penkoff, AU.D.
• Guy Anthony Penn, PA-C
• Patricia Penn, PH.D.
• Samantha Penn, PHARMD

• Dermatology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.

Verify at the official NPI Registry.