Individual provider Active NPI

Lisa A Hughes, D.O.

  • Hematology & Oncology Physician
  • Traverse City, MI
National Provider Identifier
1245207695
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
011303 Issued in MI
Practice address
217 S Madison Street
Traverse City, MI 49684-2320
Phone
(231) 392-8400
Fax
(231) 935-7888
NPI assigned
Mar 3, 2006
Last updated
Mar 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 011303 MI Primary

Addresses

Primary practice location

217 S Madison Street
Traverse City, MI 49684-2320

Mailing address

2513 Momentum PL
Chicago, IL 60689-5325
Phone (231) 935-6080

Other identifiers 4

IdentifierTypeStateIssuer
3363824MedicaidMI
6408244OtherMICIGNA
LH011303OtherMIBLUE CROSS LICENSE STATE
115800635OtherMIRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmcmedonc@mhc.direct.varian.com

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
I20110114001045 MI Practitioner - Medical Oncology 1456431865 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011303MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Home Care CurrentSince Mar 1, 2016 Accepting new patients
Munson Home Care CurrentSince Mar 1, 2016 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

5041 N Royal Dr
Ste 2
Traverse City, MI 49684
Phone (231) 935-0700

550 Munson Ave
Traverse City, MI 49686
Phone (231) 935-6600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1245207695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895325",
            "telephone_number": "231-935-6080",
            "fax_number": "231-935-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S MADISON STREET",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842320",
            "telephone_number": "231-392-8400",
            "fax_number": "231-935-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "011303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3363824",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6408244",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS LICENSE STATE",
            "identifier": "LH011303",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "115800635",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcmedonc@mhc.direct.varian.com",
            "affiliation": "N",
            "address_1": "217 S Madison Street",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.