Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Lisa Andersen

Individual provider Surgical Physician Assistant · NPI 1730484312

Lisa Andersen is a Physician Assistant in Portland, Oregon. Qualified in 2012, 14 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
14
Licensed in
OR
In the registry since
2011
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Practice location Address checks out

5050 NE Hoyt St Ste 138
Portland, OR 97213-2955 Not confirmed with CMS for 12 years — call before visiting
Phone: (503) 238-1062
Fax: (503) 233-1588
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA160150 (OR)

Record details

NPI number1730484312
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 13, 2011
Last updated in NPPESFebruary 17, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients76
Services billed 174 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Legacy Clinics LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 718 clinicians in the practice; 12 are shown here.

Other providers in Portland