ROBERT RUDOLPH LISAC MD
NPI 1033613823
Pediatrics - Pediatric Hematology-Oncology in Atlanta, GA
About Robert Rudolph Lisac Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ROBERT RUDOLPH LISAC MD (NPI 1033613823) is an individual pediatric hematology-oncology provider in Atlanta, Georgia, licensed in Georgia (88026) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and maintains a secondary practice location in Jacksonville.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Robert Rudolph Lisac Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Robert Lisac reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mesa, AZ 85206
- Reassigned Medicare billing, Arizona enrollment
- Medicare enrollment name: Phoenix Children's Hospital
- 1,416 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Robert Lisac's NPI number?
The NPI number for Robert Lisac is 1033613823. It was assigned to this individual provider in the NPPES registry on March 19, 2018.
Where is Robert Lisac located?
Robert Lisac practices at 2015 Uppergate Dr #400, Atlanta, GA 30322. The listed phone number is (404) 778-4834.
What is Robert Lisac's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.
Is Robert Lisac enrolled in Medicare?
Yes. Robert Lisac is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Robert Lisac's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Robert Lisac reassigns Medicare benefits to Phoenix Children's Medical Group (Mesa, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Lisac's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Robert Lisac was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Robert Rudolph Lisac, MD · NPI 1033613823
Pediatric Hematology-Oncology physician in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since March 19, 2018.
## Identity
- **NPI:** 1033613823 (Entity type: Individual)
- **Enumerated:** March 19, 2018
- **Primary specialty:** Pediatrics - Pediatric Hematology-Oncology · taxonomy 2080P0207X
- **State license:** 88026 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 2015 UPPERGATE DR #400, Atlanta, GA 30322-6511
- **Phone:** (404) 778-4834
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Phoenix Children's Medical Group (NPI 1487814240, Mesa, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 30, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1033613823) · Data from the CMS NPPES public registry.