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LISSA BOILEAU
NPI 1174840367
Nurse Practitioner - Psychiatric/Mental Health in Ronkonkoma, NY

Active since April 27, 2010PECOS EnrolledAccepts Medicare Assignment
2 THE PLZ, RONKONKOMA, NY 11779(631) 676-2765 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 20, 2026, Feb 6, 2025 (2 updates tracked since 2025).

About Lissa Boileau NPPES

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

LISSA BOILEAU (NPI 1174840367) is an individual psychiatric/mental health provider in Ronkonkoma, New York, licensed in New York (406771) and active in the NPI registry since April 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1174840367
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameLISSA BOILEAU
Location Address2 THE PLZRonkonkoma, NY 11779-5849
Mailing Address2100 Nesconset Hwy # 1060Stony Brook, NY 11790-3503 · (646) 789-5877 · Fax (888) 253-5730
Phone(631) 676-2765
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateApril 27, 2010
Last NPPES UpdateApril 20, 20262 updates tracked since enumeration
NPPES CertifiedApril 20, 2026
✔ NPI 1174840367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · 406771
Also ListedRegistered NurseTaxonomy 163W00000X · License 22609284 (NY)
2 THE PLZ, Ronkonkoma, NY 11779
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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

Lissa Boileau 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 ID1759865991
PECOS Enrollment IDI20260325001783
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11779 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Lissa Boileau's NPI number?

The NPI number for Lissa Boileau is 1174840367. It was assigned to this individual provider in the NPPES registry on April 27, 2010.

Where is Lissa Boileau located?

Lissa Boileau practices at 2 The Plz, Ronkonkoma, NY 11779. The listed phone number is (631) 676-2765.

What is Lissa Boileau's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Lissa Boileau enrolled in Medicare?

Yes. Lissa Boileau 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.

When was this NPI record last updated?

The NPPES record for Lissa Boileau was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.