DR. JACK S LISSAUER (MD) – Gastroenterology Physician, NPI 1720087356

Gastroenterology Physician

DR. JACK S LISSAUER (MD) is a healthcare provider. based in Beachwood, Ohio. specializing in Gastroenterology Physician. They hold the professional credentials MD. They hold a License No. 35038212L (OH). The NPI Number for DR. JACK S LISSAUER (MD) is 1720087356

Main info

Male

55 Years Of Experience

Accepts Medicare Assignment

Name

DR. JACK S LISSAUER (MD)

NPI

1720087356

Phone

(216) 593-7700

Address

3700 PARK EAST DR

Enumeration Date

15 July 2005

Last Update Date

24 October 2007

Doctor Profile

Medical School Name

UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE

Secondary Phone

2165937700

Graduation Year

1971 (55 years ago)

PAC ID

9537156328

Group Practice PAC ID

6709872591

Professional Enrollment ID

I20110119000358

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience54

Completeness75

Years active:20State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for DR. JACK S LISSAUER (MD)

3700, Park East Drive, Beachwood, Cuyahoga County, Ohio, 44122, United States
SUITE 100
BEACHWOOD, OH 441224339
Phone: (216) 593-7700
Fax: (216) 593-7190
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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.

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

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 44122)

Loading plans...

Provider's Procedures

DR. JACK S LISSAUER (MD) performs procedures in Gastroenterology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
GASTROENTEROLOGY	OH	45378	Diagnostic examination of large bowel using an endoscope	51	51
GASTROENTEROLOGY	OH	45385	Removal of polyps or growths of large bowel using an endoscope	86	85

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: 6709872591View full group profile

Name	Specialty	State
PETER H GREENWALT (MD)	-	OH
MRS. JOANNE T LONGBONS (PA-C)	-	OH
Unknown Individual	-	OH
MARIA SIMON RIMMERMAN (M.D.)	-	TX
MR. JAMES JOSEPH ANDRASSY (PA-C)	-	OH

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What identifier follows DR. JACK S LISSAUER (MD) across health systems?

The NPI 1720087356 uniquely identifies DR. JACK S LISSAUER (MD) in U.S. healthcare data.

Is DR. JACK S LISSAUER (MD)'s NPI status active today?

Active status means DR. JACK S LISSAUER (MD)'s NPI record is not deactivated in the public file.

What does the directory say DR. JACK S LISSAUER (MD) does?

Insurance directories may phrase it differently, but here DR. JACK S LISSAUER (MD) maps to Gastroenterology Physician. Clinical services aligned with this taxonomy classification.

Which community is linked to DR. JACK S LISSAUER (MD)?

DR. JACK S LISSAUER (MD) shows a connection to Beachwood, Ohio in registry-derived data.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.