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LISA LIANE DIMODICA PA
NPI 1669617015
Physician Assistant in San Luis Obispo, CA

Active since December 12, 2008PECOS Enrolled
47 SANTA ROSA ST, SAN LUIS OBISPO, CA 93405(805) 542-9596 Get Directions Write a Review

NPPES record last updated: December 12, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lisa Liane Dimodica Pa NPPES

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

LISA LIANE DIMODICA PA (NPI 1669617015) is an individual physician assistant in San Luis Obispo, California, licensed in California (PA14335) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669617015
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLISA LIANE DIMODICACredential: PA
Location Address47 SANTA ROSA STSan Luis Obispo, CA 93405-5816
Mailing Address47 Santa Rosa StSan Luis Obispo, CA 93405-5816 · (805) 542-9596
Phone(805) 542-9596
Sole ProprietorNo
Enumeration DateDecember 12, 2008
✔ NPI 1669617015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA14335
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
47 SANTA ROSA ST, San Luis Obispo, CA 93405
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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 (PECOS)

Lisa Liane Dimodica Pa 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93405 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
$91.64 typical visit price
range $59.84 – $178.89
Typical copayment $22.91 (range $14.96 – $44.72)
Most-billed visit code 99203
Established Patient
$74.24 typical visit price
range $19.70 – $146.55
Typical copayment $18.56 (range $4.92 – $36.63)
Most-billed visit code 99213
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 9

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

GARY MICHAEL RAYMOND FNP
Nurse Practitioner (Family)
47 SANTA ROSA ST, 47 SANTA ROSA
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9596
MR. DAVID L GINGRICH PA
Physician Assistant
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9596
DR. JONATHAN STANLEY HAMRICK MD
Family Medicine
47 SANTA ROSA ST, 47 SANTA ROSA
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9956
FAMILY & INDUSTRIAL MEDICAL CENTER, INC.
Family Medicine
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9596
JAMES MICHAEL HARRISON MD
Family Medicine
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9596
DR. FRANK MAZZONE MD
Family Medicine
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9596
HEAL THE BRAIN WITH JANE
Occupational Therapist
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (949) 433-8457
TYLER P CAMPBELL MD
Family Medicine
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 542-9596

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 Dimodica's NPI number?

The NPI number for Lisa Dimodica is 1669617015. It was assigned to this individual provider in the NPPES registry on December 12, 2008.

Where is Lisa Dimodica located?

Lisa Dimodica practices at 47 Santa Rosa St, San Luis Obispo, CA 93405. The listed phone number is (805) 542-9596.

What is Lisa Dimodica's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Lisa Dimodica enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Lisa Dimodica was last updated on December 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.