NPIMap

Individual provider Active NPI

Lascelles Pinnock, M.D

  • Otolaryngology Physician
  • Allen Park, MI
National Provider Identifier
1295766137
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
LP042960 Issued in MI
Practice address
14575 Southfield Rd
Allen Park, MI 48101
Phone
(313) 381-5170
Fax
(313) 381-8790
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X LP042960 MI Primary

Addresses

Primary practice location

14575 Southfield Rd
Allen Park, MI 48101

Mailing address

14575 Southfield Rd
Allen Park, MI 48101
Phone (313) 381-5170

Other identifiers 12

IdentifierTypeStateIssuer
0255787002OtherMICIGNA
4033934OtherMIAETNA
13242OtherMIWELLNESS -CHSD
21165OtherMIOMNI HMO
046OtherMIHEALTH PLUS
2110638-10MedicaidMI
125274OtherMICARE CHOICES
4440296OtherMITEAMSTERS
48254OtherMIOMNI CARE CONVENTRY
OH23634OtherMIBLUE CROSS BLUE SHIELD
81165OtherMIOMNI POS
000000004774OtherMICAPE HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000131 MI Practitioner - Otolaryngology 7810916418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wayne State University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver ENT PCGroup PAC ID 6305933326, 2 clinicians

Practice addresses (Care Compare)

14575 Southfield Rd
Allen Park, MI 48101-2640
Phone (313) 381-8787

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP042960MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tel-12 Pharmacy LLC Past Accepting new patients
Downriver ENT, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lpinnock1144664@direct.hfhs.org
  • Direct secure messaging: lpinnock@direct.dmc.org

Organizations & group practices 3

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1295766137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14575 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "48101",
            "telephone_number": "313-381-5170",
            "fax_number": "313-381-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14575 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "48101",
            "telephone_number": "313-381-5170",
            "fax_number": "313-381-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINNOCK",
        "first_name": "LASCELLES",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "LP042960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0255787002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4033934",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLNESS -CHSD",
            "identifier": "13242",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNI HMO",
            "identifier": "21165",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "046",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2110638-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "125274",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEAMSTERS",
            "identifier": "4440296",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNI CARE CONVENTRY",
            "identifier": "48254",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "OH23634",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNI  POS",
            "identifier": "81165",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH",
            "identifier": "000000004774",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

Verify at the official NPI Registry.