DR. LISA ANN WHITTY BRADLEY (MD) – Plastic and Reconstructive Surgery Physician, NPI 1801808662
Plastic and Reconstructive Surgery Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. LISA ANN WHITTY BRADLEY (MD)
3601 SW 160th Ave
SUITE 250
Miramar, FL 330276308
Phone: (877) 866-7123
Fax: (855) 855-2792
Type: Location
PO BOX 781076
DETROIT, MI 482781076
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
7905 CALUMET AVE
MUNSTER, IN 463212549
Phone: (219) 836-7506
Type: Location
5454, Hohman Avenue, Old Downtown, Hammond, North Township, Lake County, Indiana, 46320, United States
HAMMOND, IN 463201931
Phone: (312) 635-2262
Type: Location
Oak Park Post Office, 4th Avenue 35th Street Alley, North Oak Park, Oak Park, Sacramento, Sacramento County, California, 95817, United States
OAK PARK, IL 603033217
Phone: (860) 922-1176
Fax: (312) 929-4026
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: 2024-07-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081212000581 | I | Family Practice | IL | TBD |
| I20240712001525 | I | Plastic And Reconstructive Surgery | IL | TBD |
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.
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 33027)
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