LISA J THACKWELL P.A.-C.
NPI 1689812257
Physician Assistant in Colorado Springs, CO

Q: What is Lisa Thackwell's NPI number?

The NPI number for Lisa Thackwell is 1689812257. It was assigned to this individual provider in the NPPES registry on February 4, 2009.

Q: What is Lisa Thackwell's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lisa Thackwell was last updated on November 30, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 04, 2009PECOS EnrolledAccepts Medicare Assignment

4190 E WOODMEN RD STE 100, COLORADO SPRINGS, CO 80920(719) 632-4455(360) 462-5181 Get Directions Write a Review

NPPES record last updated: November 30, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Lisa J Thackwell P.a.-c. NPPES

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

LISA J THACKWELL P.A.-C. (NPI 1689812257) is an individual physician assistant in Colorado Springs, Colorado, licensed in California (PA22118) and active in the NPI registry since February 2009. She is enrolled in Medicare PECOS and is a graduate of Mid West Medical College (2006).

NPPES Registry Identity

NPI1689812257

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameLISA J THACKWELLCredential: P.A.-C.

Location Address4190 E WOODMEN RD STE 100Colorado Springs, CO 80920-8075

Mailing Address960 E Green St, Suite 292Pasadena, CA 91106-2412 · (626) 449-4494 · Fax (626) 449-4474

Phone(719) 632-4455

Fax(360) 462-5181

Sole ProprietorNo

Medical School CMSMid West Medical CollegeGraduated 2006

Enumeration DateFebruary 4, 2009

Last NPPES UpdateNovember 30, 2022

NPPES CertifiedNovember 30, 2022

✔ NPI 1689812257 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 · PA22118

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.

4190 E WOODMEN RD STE 100, Colorado Springs, CO 80920

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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

Lisa J Thackwell P.a.-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 ID9931265238

PECOS Enrollment IDI20090312000227

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 6

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

124 services65 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

29 services29 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

27 services27 patients

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.

25 services22 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

11 services11 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80920 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

$89.43 typical visit price

range $58.06 – $174.82

Typical copayment $22.35 (range $14.51 – $43.70)

Most-billed visit code 99203

Established Patient

$72.20 typical visit price

range $18.88 – $142.79

Typical copayment $18.05 (range $4.72 – $35.69)

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.

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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.

CYNTHIA SULLENS NP

Nurse Practitioner