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JENNIFER ANNE LISA PMHNP-BC
NPI 1245014869
Nurse Practitioner in Dundalk, MD

Active since August 23, 2023PECOS Enrolled
1576 MERRITT BLVD STE 8, DUNDALK, MD 21222(443) 530-6921 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jennifer Anne Lisa Pmhnp-bc NPPES

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

JENNIFER ANNE LISA PMHNP-BC (NPI 1245014869) is an individual nurse practitioner in Dundalk, Maryland, licensed in Maryland (R178139) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Towson, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1245014869
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJENNIFER ANNE LISACredential: PMHNP-BC
Location Address1576 MERRITT BLVD STE 8Dundalk, MD 21222-2114
Mailing Address1576 Merritt Blvd Ste 8Dundalk, MD 21222-2114 · (443) 530-6921
Phone(443) 530-6921
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 23, 2023
Last NPPES UpdateSeptember 29, 2025
NPPES CertifiedSeptember 29, 2025
✔ NPI 1245014869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MD · R178139
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1576 MERRITT BLVD STE 8, Dundalk, MD 21222
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Secondary Practice Location 1

Location 1920 Providence Rd Ste 101Towson, MD 21286-2979 · Phone (667) 400-3679 · Fax (667) 400-3626

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Anne Lisa Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID42754020
PECOS Enrollment IDI20240701003954
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jennifer Lisa reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Aspire Wellness Center, Inc.
7.3 mi
Mental Health (Including Community Mental Health Center)
5022 CAMPBELL BLVD STE L-M
Nottingham, MD 21236
  • Reassigned Medicare billing, Maryland enrollment
  • 59 clinicians in this Medicare group
NPI 1780971630 (443) 442-1568
Alliance Wellness Solutions LLC
10 mi
Mental Health (Including Community Mental Health Center)
920 PROVIDENCE RD STE 101
Towson, MD 21286
  • Reassigned Medicare billing, Maryland enrollment
  • 4 clinicians in this Medicare group
NPI 1104604099 (667) 400-3679

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21222 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
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

Other Providers at the Same Location NPPES 7

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

MINDFUL HEALING WORKS WELLNESS CENTER, LLC
Counselor (Mental Health)
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6533
CORRINE WILKINSON
Counselor
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6533
MR. JASON ROBERT BRODY PA-C
Physician Assistant
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6533
NAILAH TURNER
Counselor (Professional)
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6921
CHRISTINA BLACKWELL LCPC
Counselor (Mental Health)
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6533
MINDFUL HEALING WORKS WELLNESS CENTER SOP
Counselor (Addiction (Substance Use Disorder))
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6533
MINDFUL HEALING WORKS WELLNESS CENTER
Clinic/Center (Mental Health (Including Community Mental Health Center))
1576 MERRITT BLVD STE 8
DUNDALK, MD 21222
Baltimore County (443) 530-6533

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 Jennifer Lisa's NPI number?

The NPI number for Jennifer Lisa is 1245014869. It was assigned to this individual provider in the NPPES registry on August 23, 2023.

Where is Jennifer Lisa located?

Jennifer Lisa practices at 1576 Merritt Blvd Ste 8, Dundalk, MD 21222. The listed phone number is (443) 530-6921.

What is Jennifer Lisa's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jennifer Lisa enrolled in Medicare?

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

Which organizations bill Medicare for Jennifer Lisa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Lisa reassigns Medicare benefits to 2 organizations: Aspire Wellness Center, Inc. (Nottingham, MD) and Alliance Wellness Solutions LLC (Towson, MD). Each 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 Jennifer Lisa'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 Jennifer Lisa was last updated on September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.