DR. LISA JANE GILLIS (MD) – Clinical Genetics (M.D.) Physician, NPI 1639680614
Clinical Genetics (M.D.) Physician
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NPPES metrics only — not quality of care.
711 GERIATRIC MEDICINE in CA
Provider Addresses for DR. LISA JANE GILLIS (MD)
9300 Valley Childrens Pl Ste 117
Madera, CA 936368761
Phone: (559) 353-6400
Type: Location
601, 5th Street South, Roser Park, Saint Petersburg, Pinellas County, Florida, 33701, United States
ST PETERSBURG, FL 337014804
Phone: (727) 767-8491
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240930002382 | I | Geriatric Medicine | DC | TBD |
| I20250603000138 | I | Medical Genetics And Genomics | MD | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 93636)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MD | |
| - | MD | |
| Internal Medicine | VA | |
| Family Practice | VA | |
| Family Practice | VA | |
| - | MD | |
| - | MD | |
| Family Practice | WV | |
| - | GA | |
| - | MD |
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