Individual provider Active NPI

Lisa D. Stagner, D.O.

  • Pulmonary Disease Physician
  • Detroit, MI
National Provider Identifier
1184792616
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5101012063 Issued in MI
Practice address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone
(313) 916-2421
Fax
(313) 916-9102
NPI assigned
Dec 1, 2006
Last updated
Oct 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101012063 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 5101012063 MI
Pulmonary Disease Physician 207RP1001X 5101012063 MI Primary

Addresses

Primary practice location

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202

Mailing address

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-2421

Other identifiers 4

IdentifierTypeStateIssuer
290H264420OtherBLUE CROSS-BLUE CROSS
LS012063OtherCHAMPUS-CHAMPUS
336313611MedicaidMI
LS012063OtherCOMMERCIAL-COMMERCIAL NUMBER

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
I20100615000872 MI Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 4486784501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-6677

2799 W Grand Blvd
Detroit, MI 48202-2608

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-6688

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101012063MIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Sep 1, 2025 Accepting new patients
Henry Ford Wyandotte Hospital Critical Care Medicine CurrentSince Sep 1, 2025 Accepting new patients
Henry Ford Wyandotte Hospital Current Accepting new patients
Henry Ford Health System Pulmonary Disease CurrentSince Jul 1, 2001 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Jul 1, 2001 Accepting new patients

Locations

23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Interoperability endpoints

  • Direct secure messaging: lstagner13018@direct.hfhs.org

Organizations & group practices 7

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 3

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1184792616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2421",
            "fax_number": "313-916-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2421",
            "fax_number": "313-916-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGNER",
        "first_name": "LISA",
        "middle_name": "D.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101012063",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "5101012063",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "5101012063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "290H264420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "LS012063",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336313611",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "LS012063",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.