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DR. LISA ANN WHITTY BRADLEY MD
NPI 1801808662
Surgery - Plastic and Reconstructive Surgery in Munster, IN

Active since August 12, 2006PECOS Enrolled
7905 CALUMET AVE, MUNSTER, IN 46321(219) 836-7506 Get Directions Write a Review

NPPES record last updated: March 16, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 16, 2021, Dec 11, 2020, Feb 11, 2019 (3 updates tracked since 2019).

About Dr. Lisa Ann Whitty Bradley Md NPPES

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

DR. LISA ANN WHITTY BRADLEY MD (NPI 1801808662) is an individual plastic and reconstructive surgery provider in Munster, Indiana, licensed in Indiana (01079522A) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Miramar.

NPPES Registry Identity

NPI1801808662
Entity TypeIndividualFemale
Primary Taxonomy2086S0122X
Provider Legal NameDR. LISA ANN WHITTY BRADLEYCredential: MD
Location Address7905 CALUMET AVEMunster, IN 46321-2549
Mailing AddressPo Box 781076Detroit, MI 48278-1076 · (317) 528-4800 · Fax (317) 865-1479
Phone(219) 836-7506
Sole ProprietorYes
Enumeration DateAugust 12, 2006
Last NPPES UpdateMarch 16, 20213 updates tracked since enumeration
NPPES CertifiedMarch 16, 2021
✔ NPI 1801808662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in IN · 01079522A
Definition

A surgeon who specializes in plastic and reconstructive surgery.

Also ListedPlastic SurgeryTaxonomy 208200000X · License 01079522B (IN)
Also ListedSurgeryTaxonomy 208600000X · License 01079522A (IN)
7905 CALUMET AVE, Munster, IN 46321
Open in Google Maps ↗

Secondary Practice Location 1

Location 13601 SW 160th Ave, SUITE 250Miramar, FL 33027-6308 · Phone (877) 866-7123 · Fax (855) 855-2792

Other Identifiers 2

Medicaid0361102441IL
Other7215166IL · Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa Ann Whitty Bradley Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
11 services11 patients

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.

JULIE MARIE LAURIDSEN AUD
Audiologist
7905 CALUMET AVE, HAMMOND CLINIC LLC
MUNSTER, IN 46321
Lake County (219) 836-5800
DR. DEVENDRA DESAI M.D.
Surgery
7905 CALUMET AVE
MUNSTER, IN 46321
Lake County (219) 836-7214
DR. WILLIAM V. HEHEMANN M.D.
Family Medicine
7905 CALUMET AVE
MUNSTER, IN 46321
Lake County (219) 836-7214
DR. MARK GORDON M.D.
Dermatology
7905 CALUMET AVE
MUNSTER, IN 46321
Lake County (219) 836-7214
DR. THOMAS T. KAMPNER M.D.
Family Medicine
7905 CALUMET AVE, HAMMOND CLINIC LLC
MUNSTER, IN 46321
Lake County (219) 836-7214
PATRICIA KONVALINKA RN, ANP
Nurse Practitioner (Adult Health)
7905 CALUMET AVE, HAMMOND CLINIC LLC
MUNSTER, IN 46321
Lake County (219) 836-7214
DR. LOUIS A. DEPORTER M.D.
Family Medicine
7905 CALUMET AVE
MUNSTER, IN 46321
Lake County (219) 836-7214
DR. THOMAS A BRUBAKER M.D.
Internal Medicine
7905 CALUMET AVE
MUNSTER, IN 46321
Lake County (219) 836-7214

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Whitty Bradley's NPI number?

The NPI number for Lisa Whitty Bradley is 1801808662. It was assigned to this individual provider in the NPPES registry on August 12, 2006.

Where is Lisa Whitty Bradley located?

Lisa Whitty Bradley practices at 7905 Calumet Ave, Munster, IN 46321. The listed phone number is (219) 836-7506.

What is Lisa Whitty Bradley's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Lisa Whitty Bradley enrolled in Medicare?

Yes. Lisa Whitty Bradley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lisa Whitty Bradley was last updated on March 16, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.