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LISA M MANDERINO
NPI 1790288066
Clinical Neuropsychologist in Louisville, KY

Active since March 13, 2018PECOS EnrolledAccepts Medicare Assignment
3615 NEWBURG RD, LOUISVILLE, KY 40218(502) 909-0772(855) 859-0123 Get Directions Write a Review

NPPES record last updated: October 13, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 13, 2022, Jul 18, 2022, Mar 13, 2018 (3 updates tracked since 2018).

About Lisa M Manderino NPPES

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

LISA M MANDERINO (NPI 1790288066) is an individual clinical neuropsychologist in Louisville, Kentucky and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1790288066
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameLISA M MANDERINO
Location Address3615 NEWBURG RDLouisville, KY 40218-3368
Mailing Address3615 Newburg RdLouisville, KY 40218-3368 · (502) 909-0772 · Fax (855) 859-0123
Phone(502) 909-0772
Fax(855) 859-0123
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 13, 2018
Last NPPES UpdateOctober 13, 20223 updates tracked since enumeration
NPPES CertifiedOctober 13, 2022
✔ NPI 1790288066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
3615 NEWBURG RD, Louisville, KY 40218
Open in Google Maps ↗

Other Identifiers 1

Other276504KY · State License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa M Manderino 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 ID8729457882
PECOS Enrollment IDI20221212001737
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 Lisa Manderino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Aptiva Health
Same address
Orthopaedic Surgery
3615 NEWBURG RD
Louisville, KY 40218
  • Reassigned Medicare billing, Kentucky enrollment
  • 34 clinicians in this Medicare group
NPI 1669967881 (502) 812-1002

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.

HANNAH MARIE RICHARDSON PSYD
Clinical Neuropsychologist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
ANTHONY KOLTER PT
Physical Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
SYDNEY M CAWVEY PT
Physical Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
MICHAEL E GILBERT PA-C
Physician Assistant
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
BROOKE DUNCAN STACY
Massage Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
AKILAH FLAHERTY
Physical Therapy Assistant
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
DR. JAMES STEVE SMITH MD
Orthopaedic Surgery
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772
DILLON PRUETT DPT
Physical Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Jefferson County (502) 909-0772

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 Manderino's NPI number?

The NPI number for Lisa Manderino is 1790288066. It was assigned to this individual provider in the NPPES registry on March 13, 2018.

Where is Lisa Manderino located?

Lisa Manderino practices at 3615 Newburg Rd, Louisville, KY 40218. The listed phone number is (502) 909-0772.

What is Lisa Manderino's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Lisa Manderino enrolled in Medicare?

Yes. Lisa Manderino is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Lisa Manderino's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Manderino reassigns Medicare benefits to Aptiva Health (Louisville, KY). 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 Lisa Manderino's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Manderino accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Lisa Manderino as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Manderino was last updated on October 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.