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

MS. Lisa Siracusa, RPA

Individual provider Surgical Physician Assistant · NPI 1104072909

MS. Lisa Siracusa, RPA is a Physician Assistant in Staten Island, New York. Qualified in 1993, 33 years ago. Practices with Advanced Surgical Radiology LLC, a 9-clinician group and works from 2 locations. Licensed in New Jersey and New York.

Years since qualifying
33
Licensed in
NJ, NY
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

305 Seguine Ave Ste Two
Staten Island, NY 10309-3730
Phone: (718) 966-7009
Fax: (718) 948-7514
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 81 Veronica Ave Ste 205, Somerset, NJ 08873-3491 — (732) 640-5316

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 25MP00315900 (NJ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 004641 (NY)

Record details

NPI number1104072909
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPA
Sole proprietorNo
NPI enumeratedAugust 12, 2008
Last updated in NPPESJanuary 29, 2026
Certification dateJanuary 29, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Advanced Surgical Radiology Llc — 9 clinicians
Accepts Medicare assignment Not indicated

Other providers in Staten Island