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MRS. LISA RUTH MCLEAN PA-C
NPI 1114476140
Physician Assistant - Medical in Allen Park, MI

Active since October 03, 2016PECOS Enrolled
17500 FEDERAL DR STE 750, ALLEN PARK, MI 48101(313) 982-1370(313) 982-1376 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 29, 2021, Jun 28, 2018, Apr 13, 2017 (3 updates tracked since 2017).

About Mrs. Lisa Ruth Mclean Pa-c NPPES

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

MRS. LISA RUTH MCLEAN PA-C (NPI 1114476140) is an individual medical provider in Allen Park, Michigan, licensed in Michigan (5601008938) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1114476140
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. LISA RUTH MCLEANCredential: PA-C
Location Address17500 FEDERAL DR STE 750Allen Park, MI 48101-3656
Mailing Address17500 Federal Dr Ste 750Allen Park, MI 48101-3656 · (313) 982-1370 · Fax (313) 982-1376
Phone(313) 982-1370
Fax(313) 982-1376
Sole ProprietorNo
Enumeration DateOctober 3, 2016
Last NPPES UpdateApril 29, 20213 updates tracked since enumeration
NPPES CertifiedApril 29, 2021
✔ NPI 1114476140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in MI · 5601008938✔ Licensed in CA · PA53731
Also ListedPreventive Medicine · Occupational MedicineTaxonomy 2083X0100X · License 5601008938 (MI)
17500 FEDERAL DR STE 750, Allen Park, MI 48101
Open in Google Maps ↗

Other Names 1

Former Name (1)Lisa Ruth Cocco Pa-c

Secondary Practice Locations 3

Location 1301 Industrial rdSan Carlos, CA 94070-2603 · Phone (650) 596-4000
Location 214911 National AveLos Gatos, CA 95032-2632 · Phone (408) 358-3511
Location 31998 Market StSan Francisco, CA 94102 · Phone (415) 792-4060

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lisa Ruth Mclean Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Mclean's NPI number?

The NPI number for Lisa Mclean is 1114476140. It was assigned to this individual provider in the NPPES registry on October 3, 2016. The provider is also known as Lisa Ruth Cocco Pa-C.

Where is Lisa Mclean located?

Lisa Mclean practices at 17500 Federal Dr Ste 750, Allen Park, MI 48101. The listed phone number is (313) 982-1370.

What is Lisa Mclean's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Lisa Mclean enrolled in Medicare?

Yes. Lisa Mclean is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lisa Mclean was last updated on April 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.