Individual provider Active NPI

Sara Lieblein Simons, M.D.

  • Obstetrics & Gynecology Physician
  • Utica, MI
National Provider Identifier
1528447984
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301107261 Issued in MI
Practice address
11051 Hall Rd Ste 110
Utica, MI 48317-5737
Phone
(586) 726-6556
Fax
(586) 726-6556
NPI assigned
May 19, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301107261 MI Primary

Addresses

Primary practice location

11051 Hall Rd Ste 110
Utica, MI 48317-5737

Mailing address

3034 Woodslee Dr
Royal Oak, MI 48073-2937
Phone (248) 535-3259

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1043

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slieblein86818@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200214001009 MI Practitioner - Obstetrics/Gynecology 7719289974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinton Womens Healthcare PCGroup PAC ID 2264446897, 5 clinicians

Practice addresses (Care Compare)

11051 Hall Rd
Suite 110
Utica, MI 48317-5737
Phone 58672665562

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince May 30, 2020 Accepting new patients
Clinton Women's Healthcare, PC Obstetrics & Gynecology CurrentSince Dec 10, 2019 Accepting new patients
Environ Anesthesia, LLC. PastSince Dec 10, 2019 Accepting new patients

Locations

6483 Citation Dr
Ste A
Clarkston, MI 48346
Phone (248) 751-1025

48801 Romeo Plank Rd
Ste 103A
Macomb, MI 48044
Phone (248) 689-1000

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

11051 Hall Rd
Ste 110
Utica, MI 48317
Phone (586) 726-6556

Interoperability endpoints

  • Direct secure messaging: sarasimons@cwhpc.allscriptsdirect.net
  • Direct secure messaging: slieblein86818@direct.beaumont.edu
  • Direct secure messaging: ssimons1256068@epic00.shdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528447984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3034 WOODSLEE DR",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732937",
            "telephone_number": "248-535-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11051 HALL RD STE 110",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483175737",
            "telephone_number": "586-726-6556",
            "fax_number": "586-726-6556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-1043",
            "fax_number": "248-964-0692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "SARA",
        "middle_name": "LIEBLEIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301107261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slieblein86818@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Utica, MI

Sources for this page

Verify at the official NPI Registry.