Lisa Petronella Shock, PA - Medicare Physician Assistant in Raleigh, NC

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Lisa Petronella Shock, PA is a medicare enrolled "Physician Assistant" in Raleigh, North Carolina. Her current practice location is 4909 Green Rd, Raleigh, North Carolina. You can reach out to her office (for appointments etc.) via phone at (919) 790-0288.

Lisa Petronella Shock is licensed to practice in North Carolina (license number 102885) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962439745.

Contact Information

Lisa Petronella Shock, PA
4909 Green Rd,
Raleigh, NC 27616-3418
(919) 790-0288
Not Available

Map and Direction




Provider's Profile

Full NameLisa Petronella Shock
GenderFemale
SpecialityPhysician Assistant
Location4909 Green Rd, Raleigh, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1962439745
  • Provider Enumeration Date: 06/27/2006
  • Last Update Date: 07/10/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 2466414669
  • Enrollment ID: I20100525001076

Medical Identifiers

Medical identifiers for Lisa Petronella Shock such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962439745NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 6237 (Tennessee)Secondary
363A00000XPhysician Assistant 102885 (North Carolina)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Petronella Shock allows following entities to bill medicare on her behalf.
Entity NameInpatient Consultants of North Carolina PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669422846
PECOS PAC ID: 5991720591
Enrollment ID: O20051012001172
Entity NameAmerican Current Care of North Carolina PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306015102
PECOS PAC ID: 8426196098
Enrollment ID: O20091119000309
Entity NameNM Pacs 2 LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366928749
PECOS PAC ID: 3375892060
Enrollment ID: O20200109003016
Entity NameTheoria Medical
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609362375
PECOS PAC ID: 5395098339
Enrollment ID: O20210429000604
Entity NameCS Pacs 3 Southeast LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154104958
PECOS PAC ID: 8426404302
Enrollment ID: O20240815002813

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Petronella Shock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lisa Petronella Shock, PA
1929 Kateland Ct,
Apex, NC 27502-6611

Ph: (919) 593-1557		Lisa Petronella Shock, PA
4909 Green Rd,
Raleigh, NC 27616-3418

Ph: (919) 790-0288

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.