Individual provider Active NPI

Christine Malinowski, DNP, RN, FNP-BC

  • Family Nurse Practitioner
  • Wyandotte, MI
National Provider Identifier
1376052977
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704299176 Issued in MI
Practice address
375 Eureka Rd Ste B
Wyandotte, MI 48192-5839
Phone
(734) 225-9300
NPI assigned
Sep 26, 2017
Last updated
Sep 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704299176 MI Primary

Addresses

Primary practice location

375 Eureka Rd Ste B
Wyandotte, MI 48192-5839

Mailing address

17197 N Laurel Park Dr Ste 107
Livonia, MI 48152-7910

Other identifiers 1

IdentifierTypeStateIssuer
4704299176OtherMILICENSE

Other names 1

  • Christine Lazuka Former name

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
I20171102002303 MI Practitioner - Nurse Practitioner 6103182464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epmg Downriver PLLCGroup PAC ID 6608038443, 32 clinicians

Practice addresses (Care Compare)

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epmg Downriver PLLC CurrentSince Apr 3, 2019 Accepting new patients

Locations

23050 West Rd
Brownstown Twp, MI 48183
Phone (734) 287-9880

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

  • Direct secure messaging: clazuka372688@direct.hfhs.org

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, 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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1376052977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17197 N LAUREL PARK DR STE 107",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481527910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 EUREKA RD STE B",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925839",
            "telephone_number": "734-225-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINOWSKI",
        "first_name": "CHRISTINE",
        "credential": "DNP, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704299176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704299176",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "LAZUKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.