Individual provider Active NPI

Lisa Mariane Bronaugh, NP

  • Family Nurse Practitioner
  • Easton, MD
National Provider Identifier
1932651700
Registry record updated Sep 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R206308 Issued in MD
Practice address
607 Dutchmans LN
Easton, MD 21601-3345
Phone
(410) 822-9133
Fax
(410) 822-9513
NPI assigned
Oct 27, 2016
Last updated
Sep 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R206308 MD Primary

Addresses

Primary practice location

607 Dutchmans LN
Easton, MD 21601-3345

Mailing address

219 S Washington St
Easton, MD 21601-2913
Phone (410) 822-9133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20170112001102 MD Practitioner - Nurse Practitioner 4385926070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.26 of 100Reported as group
Quality
81.56
Promoting interoperability
100
Improvement activities
40
Cost
69.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 24, 2018 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 24, 2018 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

607 Dutchmans Ln
Easton, MD 21601
Phone (410) 822-8447

8579 Commerce Dr
Ste 104
Easton, MD 21601
Phone (410) 822-8550

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

Interoperability endpoints

  • Direct secure messaging: bronaugh.lisa.001.0200013@mrp.meditab.direct-ci.com
  • Direct secure messaging: lbronaugh475634@direct.umm.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538179200000",
    "number": "1932651700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S WASHINGTON ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012913",
            "telephone_number": "410-822-9133",
            "fax_number": "410-822-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 DUTCHMANS LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013345",
            "telephone_number": "410-822-9133",
            "fax_number": "410-822-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONAUGH",
        "first_name": "LISA",
        "middle_name": "MARIANE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2018-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R206308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.