Active NPI
Lyle Victor, MD
- Pulmonary Disease Physician
- Canton, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 4301038979
- Practice address
- 42180 Ford Rd Ste 201
Canton, MI 48187-3676 - Phone
- (734) 844-6075
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 4301038979 | MI | Primary |
Addresses
Primary practice location
42180 Ford Rd Ste 201
Canton, MI 48187-3676
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104530220 | Medicaid | MI | |
| 290H216580 | Other | MI | BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lvictor109839@direct.beaumont.edu |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Icahn School of Medicine at Mount Sinai, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18100 Oakwood Blvd
Dearborn, MI 48124-4085
18101 Oakwood Blvd
Dearborn, MI 48124-4089
28080 Grand River Ave
Suite 306N
Farmington Hills, MI 48336-5966
Phone (947) 521-4771
28100 Grand River Ave
Farmington Hills, MI 48336-5970
5452 Fort St
Suite 200
Trenton, MI 48183-4638
Phone (734) 642-2295
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakwood Ambulatory, LLC | Current | Accepting new patients | |
| Oakwood Ambulatory LLC | Current | Accepting new patients | |
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients | |
| Michigan Multispecialty Physicians, P.C. | Pulmonary Disease | Past | Accepting new patients |
| Oakwood Healthcare, Inc. | Past | Accepting new patients | |
| Oakwood Healthcare Inc | Past | Accepting new patients |
Locations
201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065
42180 Ford Rd
Ste 201
Canton, MI 48187
Phone (734) 844-6042
18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780
28080 Grand River Ave
Ste 306N
Farmington Hills, MI 48336
Phone (947) 521-4771
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
39000 7 Mile Rd
Ste 4200
Livonia, MI 48152
Phone (947) 523-4410
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
5452 Fort St
Ste 200
Trenton, MI 48183
Phone (734) 642-2295
Interoperability endpoints
- lvictor1260204@epic00.shdirect.org
Organizations & group practices 6
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1003829441
-
- Podiatrist
- Westland, MI
- NPI 1013157361
-
- Critical Care Medicine (Internal Medicine) Physician
- Ypsilanti, MI
- NPI 1912941337
Pulmonary Disease
-
- Community/Retail Pharmacy
- Westland, MI
- NPI 1033128178
-
- General Acute Care Hospital
- Trenton, MI
- NPI 1740230648
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1447230669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42180 FORD RD STE 201",
"city": "CANTON",
"state": "MI",
"postal_code": "481873676",
"telephone_number": "734-844-6075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICTOR",
"first_name": "LYLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MI",
"license": "4301038979",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104530220",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "290H216580",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lvictor109839@direct.beaumont.edu",
"affiliation": "N",
"address_1": "42180 Ford Rd Ste 201",
"city": "Canton",
"state": "MI",
"country_code": "US",
"postal_code": "481873676",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.