Individual provider Active NPI

Carol Anne Lukas, NP

  • Primary Care Nurse Practitioner
  • Howell, MI
National Provider Identifier
1285821538
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704208250 Issued in MI
Practice address
1333 W Grand River Ave
Howell, MI 48843-1980
Phone
(517) 548-1900
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704208250 MI
Primary Care Nurse Practitioner 363LP2300X 4704208250 MI Primary

Addresses

Primary practice location

1333 W Grand River Ave
Howell, MI 48843-1980

Mailing address

41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818
Phone (248) 660-1220

Other identifiers 2

IdentifierTypeStateIssuer
1285821538MedicaidMI
11904589OtherCAQH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071214000702 MI Practitioner - Nurse Practitioner 7517057490 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

3003 W Grand River Ave
Howell, MI 48843-8539
Phone (517) 546-4210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704208250MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Nurse Practitioner CurrentSince Dec 2, 2024 Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince Jun 10, 2025 Accepting new patients
Theoria Medical Nurse Practitioner Past Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

3003 W Grand River Ave
Howell, MI 48843
Phone (517) 323-9133

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1285821538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "248-660-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431980",
            "telephone_number": "517-548-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKAS",
        "first_name": "CAROL",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704208250",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704208250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285821538",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11904589",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

Verify at the official NPI Registry.