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

Sean Ervin Lisk, PA-C

Individual provider Medical Physician Assistant · NPI 1104252972

Sean Ervin Lisk, PA-C is a Physician Assistant in New Haven, Connecticut. Graduated from University of Washington School of Medicine in 2014, 12 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut and Maine.

Years since qualifying
12
Trained at
University of Washington School of Medicine
Licensed in
CT, ME
In the registry since
2013
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

20 York St
New Haven, CT 06510-3220
Phone: (203) 688-2615
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 22 Bramhall St, Portland, ME 04102-3134 — (207) 662-2414

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 3811 (CT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA1495 (ME)

Record details

NPI number1104252972
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2013
Last updated in NPPESDecember 28, 2021
Certification dateDecember 28, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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