Individual provider Active NPI

Lisa Anita Tully, MD

  • Cardiovascular Disease Physician
  • Mendham, NJ
National Provider Identifier
1043485055
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA09709600 Issued in NJ
Practice address
8 Tempe Wick Rd
Mendham, NJ 07945-1814
Phone
(973) 543-2288
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NJ
Cardiovascular Disease Physician 207RC0000X 25MA09709600 NJ Primary

Addresses

Primary practice location

8 Tempe Wick Rd
Mendham, NJ 07945-1814

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (973) 656-6280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150908001174 NJ Practitioner - Cardiovascular Disease (Cardiology) 7517273410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians
Cardiovascular Health Consultants, P.a.Group PAC ID 8325934706, 118 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

1125 US Hwy 22
Suite 170
Bridgewater, NJ 08807-2939
Phone (908) 947-7011

333 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone (973) 895-6601

8 Tempe Wick Rd
Mendham, NJ 07945-1814
Phone (973) 543-2288

95 Madison Ave
Suite 204
Morristown, NJ 07960-6390
Phone (973) 971-7440

95 Madison Ave
Suite 304
Morristown, NJ 07960-6389
Phone (973) 971-7165

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Health Consultants, P.a. CurrentSince Sep 1, 2015 Accepting new patients
Practice Associates Medical Group CurrentSince Sep 1, 2015 Accepting new patients

Locations

8 Tempe Wick Rd
Mendham, NJ 07945
Phone (973) 543-2288

95 Madison Ave
Ste 300
Morristown, NJ 07960
Phone (973) 898-0400

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

Organizations & group practices 2

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1043485055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "973-656-6280",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 TEMPE WICK RD",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451814",
            "telephone_number": "973-543-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "LISA",
        "middle_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA09709600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendham, NJ

Sources for this page

Verify at the official NPI Registry.