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MIKAELA DOCENA LISING
NPI 1629611439
Audiologist in Loma Linda, CA

Active since October 24, 2019
11201 BENTON ST, LOMA LINDA, CA 92357(909) 825-7084 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 27, 2025, Oct 24, 2019 (2 updates tracked since 2019).

About Mikaela Docena Lising NPPES

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

MIKAELA DOCENA LISING (NPI 1629611439) is an individual audiologist in Loma Linda, California, licensed in California (3457) and active in the NPI registry since October 2019.

NPPES Registry Identity

NPI1629611439
Entity TypeIndividualFemale
Primary Taxonomy231H00000X
Provider Legal NameMIKAELA DOCENA LISING
Location Address11201 BENTON STLoma Linda, CA 92357-1000
Mailing Address1555 Orange Ave Unit 702Redlands, CA 92373-1455
Phone(909) 825-7084
Sole ProprietorNo
Enumeration DateOctober 24, 2019
Last NPPES UpdateMay 27, 20252 updates tracked since enumeration
✔ NPI 1629611439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers
Taxonomy Code231H00000X
License✔ Licensed in CA · 3457
Definition
(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
11201 BENTON ST, Loma Linda, CA 92357
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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)

Mikaela Docena Lising is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Southern California Permanente Medical Group
11 mi
Health Maintenance Organization
9961 SIERRA AVE
Fontana, CA 92335
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1689606196 (909) 427-3910

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.

DR. ARTHUR CHUNG-LIUNG CHANG M.D.
Radiology (Diagnostic Radiology)
11201 BENTON ST, VA LOMA LINDA HEALTHCARE SYSTEM - DEPT OF RADIOLOGY
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
JUNGMI LEE LCSW
Social Worker (Clinical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PETRU PAPACOSTEA
Internal Medicine
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PATTY J DALLMEIER RRT
Respiratory Therapist, Registered (Pulmonary Diagnostics)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PATTY BEAVER LSW
Counselor (Mental Health)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 674-2794
DR. KRYSTAL GREGG PSYD
Psychologist (Clinical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
HOLLY CORNEJO FNP-C
Nurse Practitioner (Family)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
MS. RINA JOLEANNY CRUZ REGISTERED NURSE
Registered Nurse (Medical-Surgical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084

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 Mikaela Lising's NPI number?

The NPI number for Mikaela Lising is 1629611439. It was assigned to this individual provider in the NPPES registry on October 24, 2019.

Where is Mikaela Lising located?

Mikaela Lising practices at 11201 Benton St, Loma Linda, CA 92357. The listed phone number is (909) 825-7084.

What is Mikaela Lising's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Is Mikaela Lising enrolled in Medicare?

Yes. Mikaela Lising is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mikaela Lising's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mikaela Lising reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). 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 Mikaela Lising'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 Mikaela Lising was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.