Lisa Long (NPI# 1356831572, PAC ID# 1153666425) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1356831572 |
| PAC ID by PECOS | 1153666425 |
| Professional Enrollment ID | I20181214002774 |
| Full Name | Lisa Long |
| Organization Legal Name | EPIPHANY DERMATOLOGY OF NEW MEXICO, LLC |
| Address |
No 5 Calle Medico Suite A Santa Fe NM 87505-4762 |
| Phone Number | 5055576300 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4082919691 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 | 5055576300 | EPIPHANY DERMATOLOGY OF NEW MEXICO, LLC |
| Organization Legal Name | EPIPHANY DERMATOLOGY OF NEW MEXICO, LLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shana E Peterson | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| Janice F Moranz | Dermatology | Epiphany Dermatology of New Mexico, LLC | 5600 Eubank Blvd Ne, Suite 110, Albuquerque, NM 87111-1519 |
| Mary Catherine Curry | Dermatology | Epiphany Dermatology of New Mexico, LLC | 5512 E Main St, Suite A, Farmington, NM 87402-4421 |
| Donald D Harville | Dermatology | Epiphany Dermatology of New Mexico, LLC | 8316 Kaseman Ct Ne, Albuquerque, NM 87110-7639 |
| Ryan L Holcomb | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| Timothy E Busch | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | 5600 Eubank Blvd Ne, Suite 110, Albuquerque, NM 87111-1519 |
| John K Clayshulte Iii | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | 5600 Eubank Blvd Ne, Suite 110, Albuquerque, NM 87111-1519 |
| Pooneh Newton | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | 5600 Eubank Blvd Ne, Suite 110, Albuquerque, NM 87111-1519 |
| Anne Woodling | Nurse Practitioner | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| James Kerner | Dermatology | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| Street Address |
NO 5 CALLE MEDICO SUITE A |
| City | SANTA FE |
| State | NM |
| Zip | 87505-4762 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shana E Peterson | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| Ryan L Holcomb | Physician Assistant | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| Anne Woodling | Nurse Practitioner | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| James Kerner | Dermatology | Epiphany Dermatology of New Mexico, LLC | No 5 Calle Medico, Suite A, Santa Fe, NM 87505-4762 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly Jamison | Nurse Practitioner | Presbyterian Healthcare Services | 454 St Michaels, Santa Fe, NM 87505 |
| Sanjay Bardwaj | Physical Therapy | Sf Sports Md and Rehab | 104 Old Las Vegas Hwy, Santa Fe, NM 87505 |
| Laura K Merrigan | Nurse Practitioner | Presbyterian Healthcare Services | 454 St Michaels, Santa Fe, NM 87505 |
| Nancy C Lehrhaupt | Nurse Practitioner | Presbyterian Healthcare Services | 454 St Michaels, Santa Fe, NM 87505 |
| Candace R Kenyon | Physical Therapy | Sf Sports Md and Rehab | 104 Old Las Vegas Hwy, Santa Fe, NM 87505 |
| Alyson F Yacono | Physical Therapy | Sf Sports Md and Rehab | 104 Old Las Vegas Hwy, Santa Fe, NM 87505 |
| Thomas Longley | Family Medicine | Presbyterian Healthcare Services | 454 St Michaels, Santa Fe, NM 87505 |
| Amy Jelliffe | Psychiatry | Presbyterian Healthcare Services | 454 St Michaels, Santa Fe, NM 87505 |
| Melinda M Ramirez | Physical Therapy | Sf Sports Md and Rehab | 104 Old Las Vegas Hwy, Santa Fe, NM 87505 |
| Kamasamudram Ravilochan | Neurology | Presbyterian Healthcare Services | 454 St Michaels, Santa Fe, NM 87505 |
| Find all physicians in zip 87505 | |||
| City | SANTA FE |
| Zip Code | 87505 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SANTA FE + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.