Lisa Ann Bourquin, FNP-APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

77653-33 Issued in WI

Practice address

1 Medical Center Dr
Galena, IL 61036-8118

Phone

(815) 777-1340

NPI assigned

Jul 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Lisa Ann Byro Former name

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Medical CenterGroup PAC ID 5698771848, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Midwest Medical Center Hospital, Galena, IL, CCN 141302

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: midwestmedical@midwestmedicalcenter.cernerdirect.com

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.

• Midwest Medical Center

  • Critical Access Hospital
  • Galena, IL
  • NPI 1952409765
  Medicare reassignment Care Compare group NPD
• Midwest Medical Center

  • Rural Health Clinic/Center
  • Elizabeth, IL
  • NPI 1295286045
  NPD
• DMW Healthcare Solutions

  • Podiatrist
  • Chicago, IL
  • NPI 1235988965
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Midwest Medical Center

  • Clinic/Center
  • Elizabeth, IL
  • NPI 1295126944

  Hospital

  Care Compare affiliation
• Midwest Medical Center

  • Critical Access Hospital
  • Galena, IL
  • NPI 1952409765
  Care Compare affiliation

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1700308558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CLAY ST",
            "city": "DARLINGTON",
            "state": "WI",
            "postal_code": "535301228",
            "telephone_number": "608-776-3614",
            "fax_number": "608-776-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368118",
            "telephone_number": "815-777-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUIN",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "77653-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "midwestmedical@midwestmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Midwest Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Medical Center Dr",
            "city": "Galena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610368118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BYRO",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• 24 Hour Care, L.L.C.
• Eric A. Ahlvin, O.D.
• Jennifer Berning, PT, DPT
• Theresa Lynn Brehm, PHARMD
• Tara Lynn Brown, PHARM D
• William Bruce-Boehler, LCSW
• Victoria Brueggert
• Melissa Jane Webb Burke, R.D.,L.D.

• Family Nurse Practitioner in Galena, IL
• Providers in Galena, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.