Individual provider Active NPI

Lekeysha Marie Robinson-Royster, M.D.

  • Family Medicine Physician
  • Southgate, MI
National Provider Identifier
1497934590
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301091301 Issued in MI
Practice address
13667 Eureka Rd
Southgate, MI 48195-1332
Phone
(734) 530-6777
NPI assigned
Oct 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301091301 MI
Family Medicine Physician 207Q00000X 1497934590 MI
Family Medicine Physician 207Q00000X 4301091301 MI Primary

Addresses

Primary practice location

13667 Eureka Rd
Southgate, MI 48195-1332

Mailing address

PO Box 746723
Atlanta, GA 30374-6723
Phone (312) 733-9730

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131002000438 MI Practitioner - Family PracticePractitioner - Emergency Medicine 0648404814 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091301MIMDEmergency Medicine Physician
1497934590MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Mi Physicians Group, PC CurrentSince Jul 6, 2020 Accepting new patients
Osh-Mi Physicians Group PC Family Medicine CurrentSince Jul 6, 2020 Accepting new patients
Osh-Mi Physicians Group PC Family Medicine Past Accepting new patients

Locations

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

13667 Eureka Rd
Southgate, MI 48195
Phone (734) 530-6777

Organizations & group practices 3

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1497934590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746723",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13667 EUREKA RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951332",
            "telephone_number": "734-530-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON-ROYSTER",
        "first_name": "LEKEYSHA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301091301",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "1497934590",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301091301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.