Individual provider Active NPI

Marc Andrew Lukosavich, D.C.

  • Chiropractor
  • Shelby Township, MI
National Provider Identifier
1023039955
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008617 Issued in MI
Practice address
48881 Hayes Rd
Shelby Township, MI 48315-4405
Phone
(586) 532-6373
Fax
(586) 532-6372
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008617 MI Primary

Addresses

Primary practice location

48881 Hayes Rd
Shelby Township, MI 48315-4405

Mailing address

48881 Hayes Rd
Shelby Township, MI 48315-4405
Phone (586) 532-6373

Other identifiers 1

IdentifierTypeStateIssuer
20-4336714MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000521 MI Practitioner - Chiropractic 6507811338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

48881 Hayes Rd
Shelby Township, MI 48315-4405
Phone (586) 532-6373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lukosavich Chiropractic Center PC Chiropractor CurrentSince Feb 24, 2006 Accepting new patients
Harper Chiropractic Center P C Chiropractor Past Accepting new patients

Locations

48881 Hayes Rd
Shelby Township, MI 48315
Phone (586) 532-6373

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1023039955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48881 HAYES RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154405",
            "telephone_number": "586-532-6373",
            "fax_number": "586-532-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48881 HAYES RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154405",
            "telephone_number": "586-532-6373",
            "fax_number": "586-532-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKOSAVICH",
        "first_name": "MARC",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-4336714",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.