NPIMap

Individual provider Active NPI

Lisa Ann Bishop, MBCHB

  • Pediatric Adolescent Medicine Physician
  • Andover, MN
National Provider Identifier
1376775437
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
51665 Issued in MN
Practice address
15245 Bluebird St NW
Andover, MN 55304
Phone
(763) 587-4600
NPI assigned
Aug 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 51665 MN Primary

Addresses

Primary practice location

15245 Bluebird St NW
Andover, MN 55304

Mailing address

8170 33Rd Ave S
Ms 21110Q
Minneapolis, MN 55425-4516
Phone (763) 587-4600

Other practice location 1

717 Delaware St SE
Minneapolis, MN 55414-2959
Phone (763) 232-6210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091029000387 MN Practitioner - Pediatric Medicine 7618014325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Inc 1,627 clinicians

Practice addresses (Care Compare)

15245 Bluebird NWST
Andover, MN 55304-3554
Phone (763) 712-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51665MNMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 5, 2009 Accepting new patients
Group Health, Inc. CurrentSince Sep 3, 2016 Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Clinics CurrentSince Oct 5, 2009 Accepting new patients
Group Health, Inc. CurrentSince Sep 3, 2016 Accepting new patients
University of Minnesota Physicians Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

15245 Bluebird St NW
Anoka, MN 55304
Phone (763) 587-4600

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2535 University Ave SE
Minneapolis, MN 55414
Phone (612) 672-2350

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

Interoperability endpoints

  • Direct secure messaging: lbishop141189@direct.healthpartners.com

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1376775437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "763-587-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "763-587-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554142959",
            "country_code": "US",
            "telephone_number": "763-232-6210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MN",
            "license": "51665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.