Individual provider Active NPI

Janann K Lishawa, DPT

  • Physical Therapist
  • South Bend, IN
National Provider Identifier
1255683132
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05010962A Issued in IN
Practice address
53880 Carmichael Dr
South Bend, IN 46635-1567
Phone
(574) 247-9441
Fax
(574) 247-9442
NPI assigned
Oct 3, 2012
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05010962A IN Primary

Addresses

Primary practice location

53880 Carmichael Dr
South Bend, IN 46635-1567

Mailing address

3600 W Bethel Ave
Muncie, IN 47304-5407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121211000548 IN Practitioner - Physical Therapist in Private Practice 2567614977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Indiana Orthopedics LLCGroup PAC ID 5698667822, 148 clinicians

Practice addresses (Care Compare)

3600 W Bethel Ave
Muncie, IN 47304-5407
Phone (765) 284-7738

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone (317) 455-1064

Merit-based Incentive Payment System (MIPS)

Final score
81.81 of 100Reported as group
Quality
64.48
Promoting interoperability
96
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Orthopedics LLC Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients
Central Indiana Orthopedics, LLC CurrentSince Aug 1, 2023 Accepting new patients
South Bend Orthopaedic Associates, Inc. Past Accepting new patients

Locations

60160 Bodnar Blvd
Mishawaka, IN 46544
Phone (574) 247-2790

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

53880 Carmichael Dr
South Bend, IN 46635
Phone (574) 234-1159

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13070/brand/2/csg/1/fhir/r4
  • Direct secure messaging: janann.lishawa.3@13070.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1255683132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISHAWA",
        "first_name": "JANANN",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010962A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.