LISA VAN DORP (PA) – Surgical Physician Assistant, NPI 1407227820

Surgical Physician Assistant

LISA VAN DORP (PA) is a healthcare provider. based in Midland, Michigan. specializing in Surgical Physician Assistant. They hold the professional credentials PA. They hold a License No. 5601007489 (MI). The NPI Number for LISA VAN DORP (PA) is 1407227820

Main info

Female

11 Years Of Experience

Accepts Medicare Assignment

Name

LISA VAN DORP (PA)

NPI

1407227820

Phone

(586) 917-8237

Address

5802 S HERITAGE CT

Enumeration Date

12 October 2015

Last Update Date

6 November 2019

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9898393385

Graduation Year

2015 (11 years ago)

PAC ID

1759691546

Group Practice PAC ID

2264323633

Professional Enrollment ID

I20181115001820

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience34

Completeness75

Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for LISA VAN DORP (PA)

5802 S HERITAGE CT
MIDLAND, MI 486403128
Phone: (586) 917-8237
Type: Mailing
4000 WELLNESS DR
MIDLAND, MI 486702000
Phone: (989) 839-3000
Type: Location

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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 48640)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 2264323633View full group profile

Name	Specialty	State
DR. JEFFREY DAVID MARTINDALE (D.O.)	Cardiovascular Disease (Cardiology)	MI
CASEY ANDERSON (PA-C)	Physician Assistant	MI
KELLI OVERWAY (APRN, FNP-BC)	Nurse Practitioner	TX
STEPHEN J MATTICHAK (MD)	Cardiovascular Disease (Cardiology), Interventional Cardiology, Cardiovascular Disease (Cardiology)	MI
DR. SUBRAMANYAM YADAM (M.D.)	Pulmonary Disease, Critical Care (Intensivists)	MI
MICHAEL DANIEL HOWSON (PA-C)	Physician Assistant	MI
DR. MARK DOUGLAS HORNESS (MD)	-	MI
MARIELLEN WAZNY (PAC)	-	MI
SHEREE CLARK (M.D.)	-	MI
JEFFERY E THOMAS (CRNA)	Certified Registered Nurse Anesthetist (Crna)	LA