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LISE MIRLINE DOMMERCANT APN
NPI 1720933716
Nurse Practitioner - Primary Care in Union, NJ

Active since March 04, 2026PECOS Enrolled

NPPES record last updated: March 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lise Mirline Dommercant Apn NPPES

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

LISE MIRLINE DOMMERCANT APN (NPI 1720933716) is an individual primary care provider in Union, New Jersey, licensed in New Jersey (26BJ15533800) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1720933716
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameLISE MIRLINE DOMMERCANTCredential: APN
Location Address1553 DAY TERUnion, NJ 07083-4719
Mailing Address1553 Day TerUnion, NJ 07083-4719 · (908) 209-7910
Phone(908) 209-7910
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 4, 2026
NPPES CertifiedMarch 4, 2026
✔ NPI 1720933716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in NJ · 26BJ15533800
1553 DAY TER, Union, NJ 07083
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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)

Lise Mirline Dommercant Apn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779042189
PECOS Enrollment IDI20260826003333
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 Reassignment

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

Renew Wound Care Of New Jersey LLC
44 mi
Family Medicine
325 JERSEY ST
Trenton, NJ 08611
  • Reassigned Medicare billing, New Jersey enrollment
  • 44 clinicians in this Medicare group
NPI 1245815851 (929) 491-7700

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07083 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

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 Lise Dommercant's NPI number?

The NPI number for Lise Dommercant is 1720933716. It was assigned to this individual provider in the NPPES registry on March 4, 2026.

Where is Lise Dommercant located?

Lise Dommercant practices at 1553 Day Ter, Union, NJ 07083. The listed phone number is (908) 209-7910.

What is Lise Dommercant's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Lise Dommercant enrolled in Medicare?

Yes. Lise Dommercant is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lise Dommercant's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lise Dommercant reassigns Medicare benefits to Renew Wound Care Of New Jersey LLC (Trenton, NJ). 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 Lise Dommercant'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 Lise Dommercant was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.