DR. LISA ANN DESTEFANO D.O
NPI 1336177674
Neuromusculoskeletal Medicine & OMM in East Lansing, MI

Q: What is Lisa Destefano's NPI number?

The NPI number for Lisa Destefano is 1336177674. It was assigned to this individual provider in the NPPES registry on June 28, 2006. The provider is also known as Dr. Lisa Ann Vredevoogd D.O..

Q: What is Lisa Destefano's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Destefano was last updated on June 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 June 28, 2006PECOS Enrolled

4660 S HAGADORN RD STE 500, EAST LANSING, MI 48823(517) 432-6144(517) 432-6150 Get Directions Write a Review

NPPES record last updated: June 29, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 7, 2021, Aug 4, 2020, Feb 13, 2017 (3 updates tracked since 2017).

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About Dr. Lisa Ann Destefano D.o NPPES

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

DR. LISA ANN DESTEFANO D.O (NPI 1336177674) is an individual neuromusculoskeletal medicine & omm provider in East Lansing, Michigan, licensed in Michigan (5101012158) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336177674

Entity TypeIndividualFemale

Primary Taxonomy204D00000X

Provider Legal NameDR. LISA ANN DESTEFANOCredential: D.O

Location Address4660 S HAGADORN RD STE 500East Lansing, MI 48823-6804

Mailing Address804 Service Rd Ste A109bEast Lansing, MI 48824-7015 · (517) 432-6144 · Fax (517) 432-6150

Phone(517) 432-6144

Fax(517) 432-6150

Sole ProprietorNo

Enumeration DateJune 28, 2006

Last NPPES UpdateJune 29, 20233 updates tracked since enumeration

NPPES CertifiedJune 29, 2023

✔ NPI 1336177674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians

Taxonomy Code204D00000X

License✔ Licensed in MI · 5101012158

Definition

The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.

4660 S HAGADORN RD STE 500, East Lansing, MI 48823

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Other Names 1

Former Name (1)Dr. Lisa Ann Vredevoogd D.o.

Other Identifiers 1

Medicaid3346153MI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa Ann Destefano D.o 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 Reassignments

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

Board Of Trustees Of Michigan State University

Same address

Orthopaedic Surgery

4660 S HAGADORN RD, STE 500
East Lansing, MI 48823

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: Michigan State University
92 clinicians in this Medicare group

NPI 1184707937 (517) 884-4554

Msu Health Care Inc

Same address

Podiatrist

4660 S HAGADORN RD STE 600
East Lansing, MI 48823

Reassigned Medicare billing, Michigan enrollment
365 clinicians in this Medicare group

NPI 1033741004 (517) 267-2460

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

12 services12 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

9%386 patients1/55-star benchmark: 85%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

22%27 patients1/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

96%344 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

10%1,041 patients1/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

35%871 patients2/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%1,041 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

19%1,041 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

50%1,041 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

DR. MARK RONALD GUGEL DO

Neuromusculoskeletal Medicine & OMM