KIMBERLY LAUREN GREENWOOD LISAC
NPI 1043994197
Counselor - Addiction (Substance Use Disorder) in Mesa, AZ
About Kimberly Lauren Greenwood Lisac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY LAUREN GREENWOOD LISAC (NPI 1043994197) is an individual addiction (substance use disorder) provider in Mesa, Arizona, licensed in Arizona (LISAC-155279) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimberly Lauren Greenwood Lisac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Greenwood reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
La Pine, OR 97739
- Reassigned Medicare billing, Arizona enrollment
- 7 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 Kimberly Greenwood's NPI number?
The NPI number for Kimberly Greenwood is 1043994197. It was assigned to this individual provider in the NPPES registry on June 9, 2023.
Where is Kimberly Greenwood located?
Kimberly Greenwood practices at 6262 E Broadway Rd Ste 110, Mesa, AZ 85206. The listed phone number is (480) 210-5570.
What is Kimberly Greenwood's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.
Is Kimberly Greenwood enrolled in Medicare?
Yes. Kimberly Greenwood is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kimberly Greenwood's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Greenwood reassigns Medicare benefits to Mavie LLC (La Pine, OR). 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 Kimberly Greenwood's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberly Greenwood accept?
Health plans from Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and UnitedHealthcare list Kimberly Greenwood 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 Kimberly Greenwood was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.
# Kimberly Lauren Greenwood, LISAC · NPI 1043994197
Addiction (Substance Use Disorder) provider in Mesa, Arizona. Individual provider, active in the CMS NPPES registry since June 9, 2023.
## Identity
- **NPI:** 1043994197 (Entity type: Individual)
- **Enumerated:** June 9, 2023
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **State license:** LISAC-155279 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 6262 E BROADWAY RD STE 110, Mesa, AZ 85206-6101
- **Phone:** (480) 210-5570
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Mavie LLC (NPI 1366270365, La Pine, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** March 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1043994197) · Data from the CMS NPPES public registry.