Active NPI
Lisa Suzanne Judge, MD
- Neonatal-Perinatal Medicine Physician
- Ypsilanti, MI
National Provider Identifier
1114981263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 4301057613
- Practice address
- 5301 McAuley Dr
Ypsilanti, MI 48197-1051 - Phone
- (734) 712-3325
- Fax
- (734) 712-5525
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 4301057613 | MI | Primary |
Addresses
Primary practice location
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Mailing address
PO Box 0446 24 Frank Lloyd Wright Dr. Lobby J
Iha
Ann Arbor, MI 48106
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4282613 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301057613 | MI | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph Mercy Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1114981263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 0446 24 FRANK LLOYD WRIGHT DR. LOBBY J",
"address_2": "IHA",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 MCAULEY DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971051",
"telephone_number": "734-712-3325",
"fax_number": "734-712-5525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDGE",
"first_name": "LISA",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "MI",
"license": "4301057613",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4282613",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.