NPIMap

Individual provider Active NPI

Mark A Brisso, MD

  • Neonatal-Perinatal Medicine Physician
  • Lincoln, NE
National Provider Identifier
1609897248
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
21523 Issued in NE
Practice address
1600 S 48TH St
Neonatolgy
Lincoln, NE 68506-1283
Phone
(402) 481-7333
Fax
(402) 481-7579
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10802 NE
Neonatal-Perinatal Medicine Physician 2080N0001X 21523 NE Primary

Addresses

Primary practice location

1600 S 48TH St
Neonatolgy
Lincoln, NE 68506-1283

Mailing address

2222 S 16TH St
Ste 400a
Lincoln, NE 68502-3796
Phone (402) 483-8590

Other identifiers 2

IdentifierTypeStateIssuer
200379810AMedicaidKS
470780857 02MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10802NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Medical Center Past Accepting new patients
Bryan Physician Network Neonatal-Perinatal Medicine Past Accepting new patients
The Physician Network Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mbrisso13567@hisp.bryanhealth.org

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1609897248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST",
            "address_2": "STE 400A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023796",
            "telephone_number": "402-483-8590",
            "fax_number": "402-483-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "address_2": "NEONATOLGY",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061283",
            "telephone_number": "402-481-7333",
            "fax_number": "402-481-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISSO",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "10802",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NE",
            "license": "21523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200379810A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470780857 02",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.