Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daria Ann Lisick, PA

Individual provider Physician Assistant · NPI 1497832125

Daria Ann Lisick, PA is a Physician Assistant in Johnson City, New York. Qualified in 1997, 29 years ago. Practices with Our Lady of Lourdes Memorial Hospital Inc, a 249-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
29
Licensed in
NY
In the registry since
2006
Specialties on file
4
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

240 Riverside Dr
Johnson City, NY 13790-2732
Phone: (607) 798-9356
Fax: (607) 797-1707
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 006573-1 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 006573 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 006573 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 006573-1 (NY)

Record details

NPI number1497832125
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 1, 2006
Last updated in NPPESOctober 26, 2016
Mailing address5719 Widewaters Pkwy, Syracuse, NY 13214-1985

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Our Lady Of Lourdes Memorial Hospital Inc — 249 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Johnson City