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

Lisa D. Mahon, PA

Individual provider Physician Assistant · NPI 1689667222

Lisa D. Mahon, PA is a Physician Assistant in Syracuse, New York. Qualified in 2001, 25 years ago. Practices with Select PT, OT and SLP Rehabilitation Ny, PLLC, a 272-clinician group. Licensed in New York.

Years since qualifying
25
Licensed in
NY
In the registry since
2005
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

5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone: (315) 251-3100
Fax: (315) 449-9923
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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 008455 (NY)

Record details

NPI number1689667222
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 30, 2005
Last updated in NPPESJuly 19, 2011

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Select Pt, Ot And Slp Rehabilitation Ny, Pllc — 272 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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