Individual provider Active NPI

Mark P Lebeis, M.D.

  • Cardiovascular Disease Physician
  • Farmington Hills, MI
National Provider Identifier
1558391003
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
049615 Issued in MI
Practice address
30055 Northwestern Hwy
Suite 220
Farmington Hills, MI 48334-3230
Phone
(248) 865-9898
Fax
(248) 865-9423
NPI assigned
Jul 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 049615 MI Primary

Addresses

Primary practice location

30055 Northwestern Hwy
Suite 220
Farmington Hills, MI 48334-3230

Mailing address

30055 Northwestern Hwy
Suite 220
Farmington Hills, MI 48334-3230
Phone (248) 865-9898

Other identifiers 1

IdentifierTypeStateIssuer
3451945MedicaidMI

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
I20040707000864 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1254318215 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049615MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Hospital Crna Current Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Mar 14, 2015 Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Mar 14, 2015 Accepting new patients
St Mary Mercy Hospital Current Accepting new patients

Locations

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558391003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY",
            "address_2": "SUITE 220",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343230",
            "telephone_number": "248-865-9898",
            "fax_number": "248-865-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY",
            "address_2": "SUITE 220",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343230",
            "telephone_number": "248-865-9898",
            "fax_number": "248-865-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEIS",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "049615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3451945",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.