Lisa Ann Whitty Bradley, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

01079522A Issued in IN

Practice address

7905 Calumet Ave
Munster, IN 46321-2549

Phone

(219) 836-7506

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

80.62 of 100Reported as group

Quality

64.25

Promoting interoperability

95

Improvement activities

40

Cost

41.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwhittybradley405609@direct.franciscanalliance.org
• Direct secure messaging: lisa.whitty.bradley.1@3342.direct.athenahealth.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.

• MD @ Home Illinois, SC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568758415

  Single Specialty

  Medicare reassignment NPD
• Skyline Wound Care Midwest LLC

  • Plastic and Reconstructive Surgery Physician
  • St. Petersburg, FL
  • NPI 1295445179

  Single Specialty

  NPD
• Peoria Surgical Group, LTD.

  • Surgery Physician
  • Peoria, IL
  • NPI 1275542045

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1801808662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7905 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212549",
            "telephone_number": "219-836-7506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 SW 160th Ave",
            "address_2": "SUITE 250",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330276308",
            "country_code": "US",
            "telephone_number": "877-866-7123",
            "fax_number": "855-855-2792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTY BRADLEY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "IN",
            "license": "01079522B",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01079522A",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IN",
            "license": "01079522A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361102441",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7215166",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwhittybradley405609@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7905 Calumet Ave",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463212549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Noah H White, PHARMD
• Taylor Whitehead
• Larkin Hugh Whitlock, CRNA
• Whittington Dermatology LLC
• Adam P Whittington, M.D.
• Wholeness Behavioral Health LLC
• Kristin Wiak
• Lorraine Kay Widdall, CNS
• Kara Wiesemann, LMHC
• Leslie Wilbanks, M.D.

• Plastic and Reconstructive Surgery Physician in Munster, IN
• Providers in Munster, IN by specialty
• Plastic and Reconstructive Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.