Individual provider Active NPI

Stacey Lemanski, MD

  • Obstetrics & Gynecology Physician
  • Warren, MI
National Provider Identifier
1114905858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301065648 Issued in MI
Practice address
11885 E 12 Mile Rd
200A
Warren, MI 48093-3474
Phone
(586) 582-7060
Fax
(586) 582-7051
NPI assigned
Jan 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301065648 MI Primary

Addresses

Primary practice location

11885 E 12 Mile Rd
200A
Warren, MI 48093-3474

Mailing address

43800 Garfield Rd
Clinton TWP, MI 48038-1136
Phone (800) 848-0202

Other identifiers 1

IdentifierTypeStateIssuer
4783298MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919001023 MI Practitioner - Obstetrics/Gynecology 2567496615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301065648MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Oct 11, 2010 Accepting new patients
Henry Ford Health St. John Hospital Obstetrics & Gynecology CurrentSince Oct 11, 2010 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Health System Past Accepting new patients

Locations

43800 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 228-4635

22151 Moross Rd
Ste 320B
Detroit, MI 48236

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22151 Moross Rd
Ste 313
Grosse Pointe, MI 48236
Phone (313) 343-3494

45634 Schoenherr Rd
Utica, MI 48315
Phone (586) 532-8440

11885 E 12 Mile Rd
#200A
Warren, MI 48093
Phone (586) 582-7060

Interoperability endpoints

  • Direct secure messaging: slemanski1139046@direct.hfhs.org

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114905858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381136",
            "telephone_number": "800-848-0202",
            "fax_number": "586-226-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD",
            "address_2": "200A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933474",
            "telephone_number": "586-582-7060",
            "fax_number": "586-582-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMANSKI",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301065648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4783298",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.