LISA BROODY (CRNP) – Family Nurse Practitioner, NPI 1487737417

LISA BROODY (CRNP) is a healthcare provider. based in Media, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. SP009148 (PA). The NPI Number for LISA BROODY (CRNP) is 1487737417

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
LISA BROODY (CRNP)
NPI
1487737417
Phone
(610) 891-3049
Address
1088 W Baltimore Pike
Enumeration Date
23 October 2006
Last Update Date
31 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6105767500
Graduation Year
2006 (20 years ago)
PAC ID
4284074311
Group Practice PAC ID
4688588866
Professional Enrollment ID
I20240506003659
Address ID
PA193123808BE1001XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for LISA BROODY (CRNP)

  • 1088 W Baltimore Pike

    Suite #2208

    Media, PA 190635146

    Phone: (610) 891-3049

    Fax: (610) 891-3919

    Type: Location

  • 1001 CHESTERBROOK BLVD

    2ND FL.

    BERWYN, PA 193120000

    Phone: (610) 576-7500

    Fax: (610) 576-7506

    Type: Mailing

  • Baltimore Pike, Bowling Green, Nether Providence Township, Delaware County, Pennsylvania, 19065, United States

    SUITE #2208

    MEDIA, PA 190635146

    Phone: (610) 891-3049

    Fax: (610) 891-3919

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240506003659INurse PractitionerPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19063)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688588866View full group profile
NameSpecialtyState
-PA
-PA
P O D I A T R YNY
-DE
A N E S T H E S I O L O G YPA
Physician AssistantNJ
Physician AssistantPA
N E U R O L O G YMD
Certified Registered Nurse Anesthetist (Crna)PA
Family PracticePA

Reviews

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Frequently asked questions

Where can patients find LISA BROODY (CRNP)'s NPI?
You can confirm LISA BROODY (CRNP) with NPI 1487737417; it appears in the national provider directory.
Is LISA BROODY (CRNP) currently active in the NPI registry?
CMS-published data lists LISA BROODY (CRNP) as an active registrant.
Can you summarize LISA BROODY (CRNP)'s specialty in plain language?
Clinically, the directory lists LISA BROODY (CRNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for LISA BROODY (CRNP)?
The page summarizes Media, Pennsylvania for LISA BROODY (CRNP); expand the address list for detail.
What if Media, Pennsylvania seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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