NPIMap

Individual provider Active NPI

Richard J Lubera, M.D.

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1457327744
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301024564 Issued in MI
Practice address
12296 E 12 Mile Rd
Warren, MI 48093-3516
Phone
(586) 751-5720
Fax
(586) 751-2206
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301024564 MI Primary

Addresses

Primary practice location

12296 E 12 Mile Rd
Warren, MI 48093-3516

Mailing address

12296 E 12 Mile Rd
Warren, MI 48093-3516
Phone (586) 751-5720

Other identifiers 3

IdentifierTypeStateIssuer
B44001OtherMIRR MEDICARE
0501632OtherMIBLUE CROSS
2724850MedicaidMI

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
I20080530000771 MI Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 4486724648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1959
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Medical Associates PCGroup PAC ID 2860743309, 23 clinicians

Practice addresses (Care Compare)

27540 Hoover Rd
Warren, MI 48093-4505
Phone (586) 754-6797

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Endoscopy & Surgery Center, L.L.C. CurrentSince Aug 1, 2019 Accepting new patients
Paramount Medical Group PC Internal Medicine Current Accepting new patients
Pioneer Medical Associates P.C. Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients
Henry Ford Health St. John Hospital Internal Medicine Past Accepting new patients

Locations

15945 19 Mile Rd
Ste 206
Clinton Township, MI 48038
Phone (586) 228-6603

15945 19 Mile Rd
Ste 204
Clinton Twp, MI 48038
Phone (586) 757-6400

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

27540 Hoover Rd
Warren, MI 48093
Phone (586) 754-3160

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

Interoperability endpoints

  • Direct secure messaging: rlubera1139580@direct.hfhs.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIBBA

Organizations & group practices 5

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 5

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1457327744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12296 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933516",
            "telephone_number": "586-751-5720",
            "fax_number": "586-751-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12296 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933516",
            "telephone_number": "586-751-5720",
            "fax_number": "586-751-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBERA",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301024564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "B44001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0501632",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2724850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.