Nicole Elizabeth Lotze, RN BSN MSN FNP-C
Individual provider Active NPI Family Nurse Practitioner · Deroit, MI
NPI 1285287201 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1285287201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704279059 (MI)
- Practice address
- Detroit Medical Center
3990 John R
Deroit, MI 48201 - Phone
- (313) 745-8525
- NPI assigned
- Jul 18, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henry Ford Wyandotte Hospital
Practice addresses (Care Compare)
15675 Northline Rd
Southgate, MI 48195-2334
Phone (734) 282-3600
Hospital & facility affiliations
- Wyandotte Hospital and Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220110000731 | MI | Practitioner - Nurse Practitioner | 1254723984 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704279059 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifetime HRT, PLLC | Current |
Accepting new patients | |
| Henry Ford Wyandotte Hospital | Current |
Accepting new patients | |
| Henry Ford Wyandotte Hospital | Current |
Accepting new patients | |
| Henry Ford Wyandotte Hospital | Current | Accepting new patients | |
| Henry Ford Wyandotte Hospital | Past | Accepting new patients |
Locations
2142 Monroe St
Ste 200
Dearborn, MI 48124
Phone (313) 444-1116
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
15675 Northline Rd
Southgate, MI 48195
Phone (734) 282-3600
2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482
Interoperability endpoints
- nlotze763655@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704279059 | MI | Yes |
Addresses
Primary practice location
Detroit Medical Center
3990 John R
Deroit, MI 48201
Mailing address
Detroit Medical Center
3990 John R
Deroit, MI 48201
Phone (313) 745-8525
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nlotze@dmc.org | Direct |
Other providers in Deroit, MI
All providers in Deroit, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.