Bradley Lisko (NPI# 1700889003, PAC ID# 5193758019) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1700889003 |
| PAC ID by PECOS | 5193758019 |
| Professional Enrollment ID | I20111123000538 |
| Full Name | Bradley Lisko |
| Organization Legal Name | POLARIS PARKWAY INTERNAL MEDICINE AND PEDIATRICS LTD |
| Address |
110 Polaris Pkwy Suite 250 Westerville OH 43082-8007 |
| Phone Number | 6148654800 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1355372962 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360017 | GRANT MEDICAL CENTER |
| 360006 | RIVERSIDE METHODIST HOSPITAL |
| 360012 | MOUNT CARMEL ST ANN'S |
| 360242 | JAMES CANCER HOSPITAL & SOLOVE RESEARCH INSTITUTE |
| 360085 | OHIO STATE UNIVERSITY STATE HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 110 Polaris Pkwy, Suite 250, Westerville, OH 43082-8007 | 6148654800 | POLARIS PARKWAY INTERNAL MEDICINE AND PEDIATRICS LTD |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_2 | Syndromic Surveillance Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | POLARIS PARKWAY INTERNAL MEDICINE AND PEDIATRICS LTD |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Mcclain | Nurse Practitioner | Polaris Parkway Internal Medicine and Pediatrics Ltd | 110 Polaris Pkwy, Suite 250, Westerville, OH 43082-8007 |
| Phillip N Simon | Internal Medicine | Polaris Parkway Internal Medicine and Pediatrics Ltd | 110 Polaris Pkwy, Suite 250, Westerville, OH 43082-8007 |
| Street Address |
110 POLARIS PKWY SUITE 250 |
| City | WESTERVILLE |
| State | OH |
| Zip | 43082-8007 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Mcclain | Nurse Practitioner | Polaris Parkway Internal Medicine and Pediatrics Ltd | 110 Polaris Pkwy, Suite 250, Westerville, OH 43082-8007 |
| Phillip N Simon | Internal Medicine | Polaris Parkway Internal Medicine and Pediatrics Ltd | 110 Polaris Pkwy, Suite 250, Westerville, OH 43082-8007 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Todd M Clark | Optometry | 395 N W St B, Westerville, OH 43082-1404 | |
| Jennifer L Weaver | Optometry | 113 Commerce Park Dr A, Westerville, OH 43082-6055 | |
| Melanie J Ballard | Optometry | Melanie J Ballard Od Ltd | 113 Commerce Park Dr A, Westerville, OH 43082-6055 |
| Jodi Kay Deistler | Physical Therapy | Ohrh, LLC | 574 N State St B, Westerville, OH 43082-6058 |
| Rashid Pervez | Psychiatry | 616 Office Pkwy B, Westerville, OH 43082-6064 | |
| Michael R Ports | Internal Medicine | Central Ohio Primary Care Physicians, Inc. | 450 Alkyre Run, Suite 380, Westerville, OH 43082-6076 |
| Kristine M Schmiesing | Internal Medicine | Central Ohio Primary Care Physicians, Inc. | 450 Alkyre Run, Suite 380, Westerville, OH 43082-6076 |
| Taylor Wucinich | Qualified Audiologist | Ohio Ear Institute LLC | 387 County Line Rd W, Suite 115, Westerville, OH 43082-6077 |
| Stacey D Winkler | Qualified Audiologist | Ohio Ear Institute LLC | 387 County Line Rd W, Suite 115, Westerville, OH 43082-6077 |
| John Ryzenman | Otolaryngology | Ohio Ear Institute LLC | 387 County Line Rd W, Suite 115, Westerville, OH 43082-6077 |
| Find all physicians in zip 43082 | |||
| City | WESTERVILLE |
| Zip Code | 43082 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | WESTERVILLE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Bradley Lisko.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.