MRS. LISA NELSON
NPI 1255715108
Nurse Practitioner - Family in Phoenix, AZ

Q: What is Lisa Nelson's NPI number?

The NPI number for Lisa Nelson is 1255715108. It was assigned to this individual provider in the NPPES registry on July 9, 2015.

Q: What is Lisa Nelson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Nelson was last updated on April 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since July 09, 2015PECOS EnrolledAccepts Medicare Assignment

4530 E MUIRWOOD DR STE 111, PHOENIX, AZ 85048(480) 961-2365 Get Directions Write a Review

NPPES record last updated: April 10, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 26, 2016, Mar 14, 2016 (2 updates tracked since 2016).

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About Mrs. Lisa Nelson NPPES

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

MRS. LISA NELSON (NPI 1255715108) is an individual family provider in Phoenix, Arizona, licensed in Arizona (AP7961) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1255715108

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. LISA NELSON

Location Address4530 E MUIRWOOD DR STE 111Phoenix, AZ 85048-7693

Mailing Address4530 E Muirwood Dr, Ste 111Phoenix, AZ 85048-7693 · (480) 961-2365 · Fax (480) 961-2382

Phone(480) 961-2365

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJuly 9, 2015

Last NPPES UpdateApril 10, 20162 updates tracked since enumeration

✔ NPI 1255715108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · AP7961

4530 E MUIRWOOD DR STE 111, Phoenix, AZ 85048

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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

Mrs. Lisa Nelson 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 ID9830497791

PECOS Enrollment IDI20260518002531

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 85048 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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 12

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

MISS AMBER MCLOUTH PA-C

Physician Assistant