BRADLEY JACK TISHMAN
NPI 1033783584
Family Medicine in La Grande, OR

Q: What is Bradley Tishman's NPI number?

The NPI number for Bradley Tishman is 1033783584. It was assigned to this individual provider in the NPPES registry on May 19, 2021.

Q: What is Bradley Tishman's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Tishman was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 19, 2021PECOS EnrolledAccepts Medicare Assignment

506 4TH ST, LA GRANDE, OR 97850(541) 663-3138(541) 975-5120 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Bradley Jack Tishman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY JACK TISHMAN (NPI 1033783584) is an individual family medicine provider in La Grande, Oregon, licensed in Oregon (DO219893) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Grande Ronde Hospital, and maintains a secondary practice location in Columbia.

NPPES Registry Identity

NPI1033783584

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameBRADLEY JACK TISHMAN

Location Address506 4TH STLa Grande, OR 97850-1906

Mailing AddressPrisma Health Medical Group Family Medicine Center, 3209 Colonial DriveColumbia, SC 29203 · (803) 434-6113 · Fax (803) 434-8478

Phone(541) 663-3138

Fax(541) 975-5120

Sole ProprietorNo

Medical School CMSLake Erie Col Of Osteo Med At Seton Hill UnivGraduated 2021

Enumeration DateMay 19, 2021

Last NPPES UpdateAugust 28, 2024

NPPES CertifiedAugust 28, 2024

✔ NPI 1033783584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OR · DO219893

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

506 4TH ST, La Grande, OR 97850

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Secondary Practice Location 1

Location 1Prisma Health Medical Group Family Medicine Center, 3209 Colonial DriveColumbia, SC 29203 · Phone (803) 434-6113 · Fax (803) 434-8478

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bradley Jack Tishman is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466991187

PECOS Enrollment IDI20240827000148

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Grande Ronde Hospital

Critical Access Hospitals · La Grande, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number381321

Location900 Sunset DriveLa Grande, OR 97850 · Union County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97850 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHELLE TOLLE D.O.

Family Medicine