Individual provider Active NPI

Lisa Michele Montelpasse, M.D.

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1487769436
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036103249 Issued in IL
Practice address
9550 W 167TH St
Orland Park, IL 60467-5561
Phone
(708) 873-4500
Fax
(708) 873-4530
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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 036103249 IL Primary

Addresses

Primary practice location

9550 W 167TH St
Orland Park, IL 60467-5561

Mailing address

9550 W 167TH St
Orland Park, IL 60467-5561
Phone (708) 873-4500

Other identifiers 2

IdentifierTypeStateIssuer
P00176029OtherR/R MEDICARE
036103249MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lmontelpasse205848@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20041214000494 IL Practitioner - Family Practice 5890752646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036103249ILMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: lmontelpasse205848@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1487769436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 W 167TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675561",
            "telephone_number": "708-873-4500",
            "fax_number": "708-873-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 W 167TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675561",
            "telephone_number": "708-873-4500",
            "fax_number": "708-873-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTELPASSE",
        "first_name": "LISA",
        "middle_name": "MICHELE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "P00176029",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103249",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmontelpasse205848@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9550 W 167th St",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604675561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "9550 W 167th St",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604675561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.