MS. LISA M. MENDELSON (NPI# 1457660243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457660243 |
| Entity Type | Individual |
| Full Name | MS. LISA M. MENDELSON |
| Credential | NURSE PRACTITIONER |
| Practice Address |
830 Harrison Ave Moakley, 3rd Floor Boston MA 02118 |
| Mailing Address |
720 Harrison Ave Dob 503 Boston MA 02118-2371 |
| Practice Telephone | 6176386428 |
| Practice Fax Number | 6176385756 |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2017-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN2258605 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN2258605 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861772568 | Lisa Mendelson | Clinical Neuropsychologist | 2446 Church Rd, Suite 3b, Toms River, NJ 08753-8182 | 2011-08-25 |
| Street Address |
830 HARRISON AVE MOAKLEY, 3RD FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316937436 | Minh Tam Truong | Radiology | 830 Harrison Ave, Moakley Building Ll100, Boston, MA 02118 | 2005-10-28 |
| 1457950131 | Maggie Ruderman | Genetic Counselor, MS | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-10-22 |
| 1760096606 | Fabio Petrocca | Student in an Organized Health Care Education/Training Program | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-09-08 |
| 1801447495 | Kailey Vitale | Speech-Language Pathologist | 830 Harrison Ave, Boston, MA 02118-2905 | 2019-09-25 |
| 1437718228 | Kayla Mcdonald | Physician Assistant | 830 Harrison Ave, Moakley, Suite 3400, Boston, MA 02118 | 2019-06-06 |
| 1154984888 | Elizabeth Tiani | Nurse Practitioner | 830 Harrison Ave, Boston, MA 02118 | 2019-04-18 |
| 1669938981 | Lynsie Rae Adams | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2019-02-11 |
| 1548754385 | Lisa Jiyoung Kim | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2018-06-15 |
| 1891226650 | Navid Alavi | Internal Medicine | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2017-03-23 |
| 1952842189 | Samuel Rubin | Otolaryngology | 830 Harrison Ave, 1st Floor, Boston, MA 02118-2905 | 2017-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018370 | Ashley Erin Dimauro | Nurse Practitioner | 155 Federal St Ste 700, Boston, MA 02110-1727 | 2019-11-18 |
| 1366961310 | Christine Anna Corallino | Nurse Practitioner | 14 Foster Street, #3, Boston, MA 02109 | 2017-09-11 |
| 1366593774 | Laurie A Talarico | Nurse Practitioner | 239 Causeway St, 2nd Floor, Boston, MA 02114-2130 | 2007-01-13 |
| 1235237173 | Katherine Concilio | Nurse Practitioner | 72 E Concord Street, Robinson 2, Boston, MA 02118 | 2006-09-21 |
| 1770191868 | Lindsey Anne Landwehrle | Nurse Practitioner | 10 Gove St, Boston, MA 02128-1931 | 2020-07-15 |
| 1356977193 | Ricky Pamphile | Nurse Practitioner | 75 Francis St, Boston, MA 02115-6110 | 2020-03-12 |
| 1184271637 | Susan Jane Ulery | Nurse Practitioner | 800 Washington St, Boston, MA 02111-1552 | 2019-08-20 |
| 1952865735 | Vanny Mclean | Nurse Practitioner | 72 E Concord Street, Robinson 2, Boston, MA 02118 | 2019-01-26 |
| 1699276808 | Neuza Barros Fernandes | Nurse Practitioner | 150 S Huntington Ave, Boston, MA 02130-4817 | 2018-02-22 |
| 1023522497 | Tram T Tran | Nurse Practitioner | 732 Harrison Ave, Preston, 2nd Floor, Boston, MA 02118 | 2017-11-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.