Active NPI
Dr. Annette C. Lacasse, D.O., P.C.
- Dermatology Physician
- Commerce TWP, MI
National Provider Identifier
1255405296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- AL007602
- Legal business name
- DR. ANNETTE C. LACASSE, D.O., P.C.
- Practice address
- 8906 Commerce Rd Ste 5
Commerce TWP, MI 48382-4484 - Phone
- (248) 363-5555
- Fax
- (248) 363-5519
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathy A Prost
- Title
- Office Manager
- Phone
- (248) 363-5555
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | AL007602 | MI | Primary |
Addresses
Primary practice location
8906 Commerce Rd Ste 5
Commerce TWP, MI 48382-4484
Mailing address
8906 Commerce Rd Ste 5
Commerce TWP, MI 48382-4484
Phone (248) 363-5555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207N00000X | Other | MI | TAXONOMY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080328000782 | MI | Part B Supplier - Clinic/Group Practice | 0345326401 |
Receives reassigned benefits from 2 practitioners Practice locations: Commerce Township, MI |
National Provider Directory
National Provider DirectoryLocations
8906 Commerce Rd
Ste 5
Commerce Twp, MI 48382
Phone (248) 363-5555
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- MOHS-Micrographic Surgery Physician
- Grand Junction, CO
- NPI 1083237796
Dermatology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1207872000000",
"number": "1255405296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8906 COMMERCE RD STE 5",
"city": "COMMERCE TWP",
"state": "MI",
"postal_code": "483824484",
"telephone_number": "248-363-5555",
"fax_number": "248-363-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8906 COMMERCE RD STE 5",
"city": "COMMERCE TWP",
"state": "MI",
"postal_code": "483824484",
"telephone_number": "248-363-5555",
"fax_number": "248-363-5519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR. ANNETTE C. LACASSE, D.O., P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-20",
"last_updated": "2008-04-11",
"status": "A",
"authorized_official_last_name": "PROST",
"authorized_official_first_name": "KATHY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "248-363-5555"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "MI",
"license": "AL007602",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY",
"identifier": "207N00000X",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Commerce TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.