Individual provider Active NPI

Lawrence Mark Eilender, MD

  • Neurology Physician
  • Southfield, MI
National Provider Identifier
1366445173
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
430040979 Issued in MI
Practice address
26400 W 12 Mile Rd
Ste 170
Southfield, MI 48034-1753
Phone
(248) 208-8787
Fax
(248) 208-8788
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 430040979 MI Primary

Addresses

Primary practice location

26400 W 12 Mile Rd
Ste 170
Southfield, MI 48034-1753

Mailing address

26400 W 12 Mile Rd
Ste 170
Southfield, MI 48034-1753
Phone (248) 208-8787

Other identifiers 1

IdentifierTypeStateIssuer
2682910-10MedicaidMI

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
I20051114001159 MI Practitioner - Neurology 2264451772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wayne State University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

26400 W 12 Mile Rd
Suite 170
Southfield, MI 48034-1753
Phone (248) 208-8787

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
430040979MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
SJMH Medical Practice-SMHC Neurology Past Accepting new patients

Locations

32255 Northwestern Hwy
Ste 100
Farmington Hills, MI 48334
Phone (248) 945-0000

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

25241 Grand River Ave
Redford, MI 48240
Phone (313) 538-3099

3601 W 13 Mile Rd
Royal Oak, MI 48073

28625 Northwestern Hwy
Ste 213
Southfield, MI 48034
Phone (248) 354-9666

26400 W 12 Mile Rd
Ste 170
Southfield, MI 48034
Phone (248) 208-8787

26400 W 12 Mile Rd
Southfield, MI 48034
Phone (248) 353-0818

Interoperability endpoints

  • Direct secure messaging: leilender59532@direct.hfhs.org

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1366445173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD",
            "address_2": "STE 170",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341753",
            "telephone_number": "248-208-8787",
            "fax_number": "248-208-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD",
            "address_2": "STE 170",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341753",
            "telephone_number": "248-208-8787",
            "fax_number": "248-208-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILENDER",
        "first_name": "LAWRENCE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "430040979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2682910-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.