Individual provider Active NPI

Christina M Lucas-Vougiouklakis, D.O.

  • Family Medicine Physician
  • Monroe, MI
National Provider Identifier
1356559496
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101016920 Issued in MI
Practice address
650 Stewart Rd
Monroe, MI 48162-4222
Phone
(734) 240-4594
NPI assigned
May 21, 2007
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101016920 MI Primary

Addresses

Primary practice location

650 Stewart Rd
Monroe, MI 48162-4222

Mailing address

650 Stewart Rd
Monroe, MI 48162-4222
Phone (734) 240-4594

Other identifiers 1

IdentifierTypeStateIssuer
0H27501OtherMIBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clucasvougiouklakis245043@epicdirect.promedica.org

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
I20100116000343 MI Practitioner - Family Practice 5597807339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6650 Stewart Rd
Monroe, MI 48162-9680
Phone (734) 240-8430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016920MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Memorial Hospital Corporation CurrentSince May 1, 2022 Accepting new patients
Mercy Memorial Hospital Corporatio CurrentSince May 1, 2022 Accepting new patients

Locations

650 Stewart Rd
Monroe, MI 48162
Phone (734) 240-4594

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

905 N Macomb St
Ste 2
Monroe, MI 48162
Phone (734) 242-1899

Interoperability endpoints

  • Direct secure messaging: clucasvougiouklakis245043@direct.promedica.org
  • Direct secure messaging: clucasvougiouklakis57598@direct.hfhs.org

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1356559496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624222",
            "telephone_number": "734-240-4594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624222",
            "telephone_number": "734-240-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS-VOUGIOUKLAKIS",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2023-11-03",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H27501",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clucasvougiouklakis245043@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.