Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

LISA DANIELLE PROCTOR APRN FNP-C
NPI 1508521584
Nurse Practitioner - Family in Tyler, TX

Q: What is Lisa Proctor's NPI number?

The NPI number for Lisa Proctor is 1508521584. It was assigned to this individual provider in the NPPES registry on November 3, 2021.

Q: What is Lisa Proctor'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 Proctor was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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 November 03, 2021PECOS EnrolledAccepts Medicare Assignment

3593 E GRANDE BLVD, TYLER, TX 75707(903) 606-1664(903) 525-1590 Get Directions Write a Review

NPPES record last updated: September 8, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 8, 2026, Nov 3, 2021 (2 updates tracked since 2021).

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About Lisa Danielle Proctor Aprn Fnp-c NPPES

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

LISA DANIELLE PROCTOR APRN FNP-C (NPI 1508521584) is an individual family provider in Tyler, Texas, licensed in Texas (1058113) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Woodville, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1508521584

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA DANIELLE PROCTORCredential: APRN FNP-C

Location Address3593 E GRANDE BLVDTyler, TX 75707-1400

Mailing Address104 N Beech StWoodville, TX 75979-4718 · (409) 283-2822

Phone(903) 606-1664

Fax(903) 525-1590

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateNovember 3, 2021

Last NPPES UpdateSeptember 8, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 8, 2026

✔ NPI 1508521584 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 TX · 1058113

3593 E GRANDE BLVD, Tyler, TX 75707

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Secondary Practice Location 1

Location 1104 N Beech StWoodville, TX 75979-4718 · Phone (409) 283-2822

Other Identifiers 1

Other1058113TX · Texas Board Of Nursing

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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

Lisa Danielle Proctor Aprn Fnp-c 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 ID8022495951

PECOS Enrollment IDI20220516001845

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.

Areas of Expertise CMS Part B claims 3

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.

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

37 services29 patients

Manual urinalysis test with examination using microscope, non-automated 81000

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

16 services14 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75707 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

ANTHONY JAMES LEE APRN, FNP-C

Nurse Practitioner (Family)