Individual provider Active NPI

Bretzyl M Liscoe

  • Critical Care Medicine Nurse Practitioner
  • Elyria, OH
National Provider Identifier
1003434952
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
APRN.CNP.0027013 Issued in OH
Practice address
630 E River St
Elyria, OH 44035-5902
Phone
(440) 323-8515
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0027013 OH
Critical Care Medicine Nurse Practitioner 363LC0200X APRN.CNP.0027013 OH Primary

Addresses

Primary practice location

630 E River St
Elyria, OH 44035-5902

Mailing address

17703 Hicks Rd
Bedford, OH 44146-4332
Phone (440) 525-0811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818001488 OH Practitioner - Nurse Practitioner 2365868684 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027013OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Ahuja Medical Center CurrentSince Jan 24, 2023 Accepting new patients
Elyria Anesthesia Incorporated CurrentSince Aug 10, 2020 Accepting new patients
University Hospitals Ahuja Medical Center, Inc Current Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jan 1, 2023 Accepting new patients
University Hospitals Ahuja Medical Center CurrentSince Jan 24, 2023 Accepting new patients

Locations

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

11100 Euclid Ave
Cleveland Heights, OH 44106

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

860 E Broad St
Ste I
Elyria, OH 44035
Phone (440) 323-8458

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

Interoperability endpoints

  • Direct secure messaging: bliscoe33002@ehrdirect.uhhospitals.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1003434952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17703 HICKS RD",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441464332",
            "telephone_number": "440-525-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-323-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISCOE",
        "first_name": "BRETZYL",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0027013",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OH",
            "license": "APRN.CNP.0027013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.