LISA MARIE LOGAN – Critical Care Medicine Nurse Practitioner, NPI 1083454995

LISA MARIE LOGAN is a healthcare provider. based in Hershey, Pennsylvania. specializing in NURSE PRACTITIONER. They hold a License No. SP029292 (PA). The NPI Number for LISA MARIE LOGAN is 1083454995

Main info

Female
3 Years Of Experience
Name
LISA MARIE LOGAN
NPI
1083454995
Phone
(800) 243-1455
Address
500 UNIVERSITY DR
Enumeration Date
29 May 2024
Last Update Date
29 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2034973861
Graduation Year
2023 (3 years ago)
PAC ID
0143765560
Group Practice PAC ID
0941562664
Professional Enrollment ID
I20240710002205
Address ID
PA191163674PH10125RDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,469 NURSE PRACTITIONER in PA

Provider Addresses for LISA MARIE LOGAN

  • 500 UNIVERSITY DR

    HERSHEY, PA 170332360

    Phone: (800) 243-1455

    Mailing address matches the actual address.

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: 2024-07-10

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
I20240710002205INurse PractitionerPATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 17033)

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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: 0941562664View full group profile
NameSpecialtyState
Nurse PractitionerCT
Nurse PractitionerCT
Nurse PractitionerCT
Nurse PractitionerTX
Nurse PractitionerCT
Nurse PractitionerCT
-CT
-CT
-CT
Nurse PractitionerCT

Reviews

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Frequently asked questions

Can I cross-check LISA MARIE LOGAN using NPI 1083454995?
NPI 1083454995 belongs to LISA MARIE LOGAN; compare other details if you need extra assurance.
Is LISA MARIE LOGAN shown as active in public data?
Registry records indicate LISA MARIE LOGAN maintains an active NPI.
What kind of doctor is LISA MARIE LOGAN?
LISA MARIE LOGAN is associated with Critical Care Medicine Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is LISA MARIE LOGAN associated with Hershey?
Public fields place LISA MARIE LOGAN around Hershey, Pennsylvania. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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