Physician Compare National (NPI:1154385706)

HEALTHCARE PROVIDER: LISA ANN CASANOVA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154385706
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335229954
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080108000508
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CASANOVA
	Individual professional last name
Provider First Name	LISA
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RIVERSIDE PHYSICIAN SERVICES INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5092608448
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	602
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	12100 WARWICK BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 202
	Group Practice or individual's line 2 address
City	NEWPORT NEWS
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	236012365
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7575944198
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490052
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RIVERSIDE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SENTARA CAREPLEX HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	490066
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y