LISA KAYE BOWERSOX (PA-C) – Physician Assistant, NPI 1942372255

LISA KAYE BOWERSOX (PA-C) is a healthcare provider. based in Petoskey, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601004147 (MI). The NPI Number for LISA KAYE BOWERSOX (PA-C) is 1942372255

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
LISA KAYE BOWERSOX (PA-C)
NPI
1942372255
Phone
(231) 487-2230
Address
4170 CEDAR BLUFF DRIVE
Enumeration Date
14 November 2006
Last Update Date
27 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6163260114
Graduation Year
2003 (23 years ago)
PAC ID
5799775516
Group Practice PAC ID
5092044487
Professional Enrollment ID
I20040514000096
Address ID
MI493167478CA1661XSEXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

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Provider Addresses for LISA KAYE BOWERSOX (PA-C)

  • Dermatology Associates of Northern Michigan, 4170, Cedar Bluff Drive, Petoskey, Emmet County, Michigan, 49770, United States

    PETOSKEY, MI 497709600

    Phone: (231) 487-2230

    Fax: (231) 487-6172

    Type: Location

  • Quick Care Medical Center, 116, West Mitchell Street, Petoskey, Emmet County, Michigan, 49770, United States

    STE 1

    PETOSKEY, MI 497702357

    Phone: (231) 348-2828

    Type: Mailing

  • 311 W MITCHELL ST

    PETOSKEY, MI 497702327

    Phone: (616) 326-0114

    Fax: (231) 487-6172

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 188 Open Payments records for all available years, with a total value of $3,376.

Total Amount is formed as General ($3,376) + Research ($0) + Ownership ($0) = $3,376.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($372).

Total Amount

$3,376

General + Research + Ownership

Payments

188

Total payment records

General Amount

$3,376

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2004-05-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040514000096IPhysician AssistantMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths47187$0
17000Destruction of precancer skin growth, 1 growth138118$0
99214Established patient office or other outpatient visit, 30-39 minutes12477$0
99203New patient office or other outpatient visit, 30-44 minutes102102$0
17110Destruction of skin growth, 1-14 growths9182$0
View full utilization report →

Insurance plans in this area (ZIP 49770)

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Provider's Procedures

LISA KAYE BOWERSOX (PA-C) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTMI17003Destruction of 2-14 skin growths13739

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: 5092044487View full group profile
NameSpecialtyState
Nurse PractitionerMI
Nurse PractitionerOH
Dermatology, PathologyMI
D E R M A T O L O G YTX
D E R M A T O L O G YMI
Dermatology, Micrographic Dermatologic Surgery (Mds)OH

Reviews

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Frequently asked questions

Is LISA KAYE BOWERSOX (PA-C) listed with a National Provider Identifier?
Yes — LISA KAYE BOWERSOX (PA-C) has NPI 1942372255 on file in the registry.
Is there an active status for LISA KAYE BOWERSOX (PA-C)?
For scheduling context, LISA KAYE BOWERSOX (PA-C) is shown as active in the registry.
What clinical focus is listed for LISA KAYE BOWERSOX (PA-C)?
At a glance, LISA KAYE BOWERSOX (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is LISA KAYE BOWERSOX (PA-C) located near Petoskey?
LISA KAYE BOWERSOX (PA-C) currently maps to Petoskey, Michigan in this extract.
Can I trust this NPI listing for LISA KAYE BOWERSOX (PA-C)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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