Active NPI
Lisa Nicole Yaxley, NP-C
- Nurse Practitioner
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704299631
- Practice address
- 3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710 - Phone
- (248) 551-1701
- NPI assigned
- Feb 6, 2017
- Last updated
- Sep 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704299631 | MI | Primary |
Addresses
Primary practice location
3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1867
Other practice location 1
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-5000
Other names 1
- Lisa Nicole Polley
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28100 Grand River Ave
Farmington Hills, MI 48336-5970
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group Hospital -Based Services | Current | Accepting new patients |
Locations
468 Cadieux Rd
Grosse Pointe Woods, MI 48230
Phone (313) 343-1000
3555 W 13 Mile Rd
Ste N120
Royal Oak, MI 48073
Phone (248) 551-1550
3601 W 13 Mile Rd
Royal Oak, MI 48073
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
Interoperability endpoints
- nyaxley1262598@epic00.shdirect.org
Organizations & group practices 2
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Beaumont Hospital-Farmington Hills
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
dba Internal Medicine Associates Farmington Hills
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1538103395
Hospital
-
dba Botsford Thoracic Surgery Clinic
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1912335373
Hospital
-
dba Beaumont Hospital, Troy
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
dba Beaumont Hospital, Royal Oak
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
dba Beaumont Hospital, Grosse Pointe
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1528506011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-1867",
"fax_number": "947-522-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 W 13 MILE RD STE N120",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736710",
"telephone_number": "248-551-1701"
}
],
"practiceLocations": [
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YAXLEY",
"first_name": "LISA",
"middle_name": "NICOLE",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-06",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704299631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "POLLEY",
"middle_name": "NICOLE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.