NPIMap

Individual provider Active NPI

Jeffrey Robert Lupovitch, MD

  • Ophthalmology Physician
  • Livonia, MI
National Provider Identifier
1366487308
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301079764 Issued in MI
Practice address
29927 Six Mile Rd
Livonia, MI 48152
Phone
(734) 522-0800
Fax
(734) 522-1236
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301079764 MI Primary

Addresses

Primary practice location

29927 Six Mile Rd
Livonia, MI 48152

Mailing address

29927 Six Mile Rd
Livonia, MI 48152
Phone (734) 522-0800

Other identifiers 12

IdentifierTypeStateIssuer
381867275OtherHARRINGTON BENEFITS
JL079764OtherMISTATE LICENSE
180F372960OtherBLUE CARE NETWORK
381867275OtherGREATLAKES
381867275OtherWPS TRICARE FOR LIFE
104933152MedicaidMI
381867275OtherAETNA
381867275OtherUNITED HEALTH CARE
OH24256OtherMIBLUE CROSS
381867275OtherCIGNA
381867275OtherGREAT LAKES
381867275OtherPPOM

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
I20060816000238 MI Practitioner - Ophthalmology 1355344102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Livonia Ophthalmologists PCGroup PAC ID 6901905520, 2 clinicians

Practice addresses (Care Compare)

29927 W 6 Mile Rd
Livonia, MI 48152-3670
Phone (734) 522-0800

Hospital & facility affiliations

  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301079764MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Livonia Ophthalmologists PC Ophthalmology CurrentSince Jan 1, 2009 Accepting new patients

Locations

29927 6 Mile Rd
Livonia, MI 48152
Phone (313) 522-0800

Interoperability endpoints

  • Direct secure messaging: jeffrey.lupovitch.1@11987.direct.athenahealth.com

Organizations & group practices 1

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 8

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1366487308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29927 SIX MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "734-522-0800",
            "fax_number": "734-522-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29927 SIX MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "734-522-0800",
            "fax_number": "734-522-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPOVITCH",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301079764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARRINGTON BENEFITS",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "JL079764",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "180F372960",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREATLAKES",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE FOR LIFE",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104933152",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "OH24256",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "381867275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "381867275",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.