Individual provider Active NPI

Macare Elizabeth Lumbrezer, DDS

  • Dentist
  • Traverse City, MI
National Provider Identifier
1457519092
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19768 Issued in MI
Practice address
555 S. Garfield Ave
Traverse City, MI 49686
Phone
(231) 947-0210
Fax
(231) 947-6770
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901019768 MI
Dentist 122300000X 19768 MI Primary

Addresses

Primary practice location

555 S. Garfield Ave
Traverse City, MI 49686

Mailing address

555 S. Garfield Ave
Traverse City, MI 49686
Phone (231) 947-0210

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110429000430 MI Practitioner - Oral Surgery 2769667096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19768MIMDDentist
2901019768MIMDGeneral Practice Dentistry

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.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1457519092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S. GARFIELD AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-947-0210",
            "fax_number": "231-947-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S. GARFIELD AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-947-0210",
            "fax_number": "231-947-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMBREZER",
        "first_name": "MACARE",
        "middle_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019768",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "19768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.