Individual provider Active NPI

Lisa Dsouza, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1508601493
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6071 Outer Dr W
Department of Internal Medicine Room M408, Transitional
Detroit, MI 48235
Phone
(313) 966-3250
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6071 Outer Dr W
Department of Internal Medicine Room M408, Transitional
Detroit, MI 48235

Mailing address

6071 Outer Dr W
Department of Internal Medicine Room M408, Transitional
Detroit, MI 48235

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
I20240812001765 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9436697232

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1508601493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 OUTER DR W",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE ROOM M408, TRANSITIONAL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 OUTER DR W",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE ROOM M408, TRANSITIONAL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-966-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DSOUZA",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.