Individual provider Active NPI

Lisa M Brinn, M.D.

  • Family Medicine Physician
  • Blue Mounds, WI
National Provider Identifier
1245338862
Registry record updated Jan 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41315 Issued in WI
Practice address
10865 Diamond Cir
Blue Mounds, WI 53517-9580
Phone
(608) 828-7603
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41315 WI Primary

Addresses

Primary practice location

10865 Diamond Cir
Blue Mounds, WI 53517-9580

Mailing address

10865 Diamond Cir
Blue Mounds, WI 53517-9580

Other practice location 1

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

Other identifiers 1

IdentifierTypeStateIssuer
1245338862MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lbrinn412795@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20080114000674 WI Practitioner - Family Practice 3779571567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

3051 Cahill Main
Fitchburg, WI 53711-7109
Phone (608) 661-7200

5249 E Terrace Dr
Madison, WI 53718-8339
Phone (608) 222-9777

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Dec 4, 2023 Accepting new patients

Locations

3051 Cahill Main
Fitchburg, WI 53711
Phone (608) 257-9700

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1265 John Q Hammons Dr
Madison, WI 53717

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

Organizations & group practices 1

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 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642809600000",
    "number": "1245338862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10865 DIAMOND CIR",
            "city": "BLUE MOUNDS",
            "state": "WI",
            "postal_code": "535179580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10865 DIAMOND CIR",
            "city": "BLUE MOUNDS",
            "state": "WI",
            "postal_code": "535179580",
            "telephone_number": "608-828-7603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462343",
            "country_code": "US",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRINN",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-01-22",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "41315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245338862",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbrinn412795@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lbrinn412795@direct-ehr-ssmhc.com",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blue Mounds, WI

Sources for this page

Verify at the official NPI Registry.