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LISA STOOTHOFF
NPI 1245889922
Student in an Organized Health Care Education/Training Program in Cortland, NY

Active since September 05, 2019PECOS Enrolled
165 MAIN ST, STE A, CORTLAND, NY 13045(607) 753-0234 Get Directions Write a Review

NPPES record last updated: September 5, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lisa Stoothoff NPPES

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

LISA STOOTHOFF (NPI 1245889922) is an individual student in an organized health care education/training program in Cortland, New York and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245889922
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameLISA STOOTHOFF
Location Address165 MAIN ST, STE ACortland, NY 13045-3049
Mailing Address165 Main St, Ste ACortland, NY 13045-3049 · (607) 753-0234
Phone(607) 753-0234
Sole ProprietorNo
Enumeration DateSeptember 5, 2019
✔ NPI 1245889922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
165 MAIN ST, Cortland, NY 13045
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Stoothoff 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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Stoothoff reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Liberty Resources Inc.
32 mi
Foster Care Agency
1045 JAMES ST
Syracuse, NY 13203
  • Reassigned Medicare billing, New York enrollment
  • 156 clinicians in this Medicare group
NPI 1447821376 (315) 472-4471

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 20

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

CHARLOTTE SWEENEY LCSW
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
PAMELA LYNN SANDERS LCSW
Social Worker (Clinical)
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
STEFANIE FELLOWS
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
ETHAN BARDELL
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
ALEXANDRA MIKOWSKI
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
MICHAEL JOHNSON
Peer Specialist
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
MALIA ROGERS MHC-LP
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
RINI SIMON CHENNATTU PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
165 MAIN ST
CORTLAND, NY 13045
Cortland County (845) 536-0732

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 Stoothoff's NPI number?

The NPI number for Lisa Stoothoff is 1245889922. It was assigned to this individual provider in the NPPES registry on September 5, 2019.

Where is Lisa Stoothoff located?

Lisa Stoothoff practices at 165 Main St Ste A, Cortland, NY 13045. The listed phone number is (607) 753-0234.

What is Lisa Stoothoff's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Lisa Stoothoff enrolled in Medicare?

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

Which organization bills Medicare for Lisa Stoothoff's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Stoothoff reassigns Medicare benefits to Liberty Resources Inc. (Syracuse, NY). 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 Lisa Stoothoff'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 Lisa Stoothoff was last updated on September 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.