MS. LISA MARIE FEDORA M.A., L.P.
NPI 1023174638
Psychologist in Duluth, MN

Active since December 28, 2006PECOS EnrolledAccepts Medicare Assignment
11 E SUPERIOR ST STE 415, DULUTH, MN 55802(218) 249-0595(218) 461-3666 Get Directions Write a Review

NPPES record last updated: March 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 29, 2023, Sep 15, 2018 (2 updates tracked since 2018).

About Ms. Lisa Marie Fedora M.a., L.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. LISA MARIE FEDORA M.A., L.P. (NPI 1023174638) is an individual psychologist in Duluth, Minnesota, licensed in Minnesota (LP4660) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1023174638
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMS. LISA MARIE FEDORACredential: M.A., L.P.
Location Address11 E SUPERIOR ST STE 415Duluth, MN 55802-3008
Mailing Address11 E Superior St Ste 415Duluth, MN 55802-3008 · (218) 249-0595 · Fax (218) 461-3666
Fax(218) 461-3666
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateDecember 28, 2006
Last NPPES UpdateMarch 29, 20232 updates tracked since enumeration
NPPES CertifiedMarch 29, 2023
NPI 1023174638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP4660
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
11 E SUPERIOR ST STE 415, Duluth, MN 55802

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Lisa Marie Fedora M.a., L.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789022112
PECOS Enrollment IDI20240404002207
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Social Worker (Clinical)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Social Worker (Clinical)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Social Worker (Clinical)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Counselor (Mental Health)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Social Worker (Clinical)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Social Worker (Clinical)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802
Counselor (Professional)
11 E SUPERIOR ST STE 415
DULUTH, MN 55802

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Fedora's NPI number?

The NPI number for Lisa Fedora is 1023174638. It was assigned to this individual provider in the NPPES registry on December 28, 2006.

Where is Lisa Fedora located?

Lisa Fedora practices at 11 E Superior St Ste 415, Duluth, MN 55802. The listed phone number is (218) 249-0595.

What is Lisa Fedora's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Lisa Fedora enrolled in Medicare?

Yes. Lisa Fedora is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lisa Fedora accept?

Health plans from HealthPartners and Security Health Plan list Lisa Fedora as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Fedora was last updated on March 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.