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: July 19, 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
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

Other Identifiers 1

Other276504KY · State License

Accepted Insurance

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 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.

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.

Physical Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Physical Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Massage Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Nurse Practitioner (Family)
3615 NEWBURG RD
LOUISVILLE, KY 40218
Physical Therapy Assistant
3615 NEWBURG RD
LOUISVILLE, KY 40218
Physical Therapist
3615 NEWBURG RD
LOUISVILLE, KY 40218
Physician Assistant
3615 NEWBURG RD
LOUISVILLE, KY 40218
Physical Therapy Assistant
3615 NEWBURG RD
LOUISVILLE, KY 40218

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790288066, enumerated as an "individual" on March 13, 2018.

The provider is located at 3615 NEWBURG RD LOUISVILLE, KY 40218 and the phone number is (502) 909-0772.

Clinical Neuropsychologist with taxonomy code 103G00000X.

The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.