LISA M. MORENO (PA-C) – Surgical Physician Assistant, NPI 1831166800
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
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Provider Addresses for LISA M. MORENO (PA-C)
2625, Divisadero Street, Fresno, Fresno County, California, 93721, United States
FRESNO, CA 937211431
Phone:
Type: Mailing
Community Regional Medical Center, 2823, Fresno Street, Fresno, Fresno County, California, 93721, United States
FRESNO, CA 937211324
Phone: (559) 459-6000
Fax: (559) 459-3750
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $163.
Total Amount is formed as General ($163) + Research ($0) + Ownership ($0) = $163.
Last reported payment date: 2023-06-06 • Largest payer in this snapshot: ABBVIE INC. ($74).
Total Amount
$163
General + Research + Ownership
Payments
9
Total payment records
General Amount
$163
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-06
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2007-01-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20070130000370 | I | Physician Assistant | CA | 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 93721)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | DC | |
| Colorectal Surgery (Proctology), General Surgery | LA | |
| - | CA | |
| N E U R O S U R G E R Y | MA | |
| Internal Medicine | CA | |
| Nurse Practitioner | CA | |
| Internal Medicine | CA | |
| Emergency Medicine | CA | |
| - | MA | |
| Emergency Medicine | CA |
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