Individual provider Active NPI

Mikhail Lyubich, MD PC

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1558473256
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0044779 Issued in GA
Practice address
340 Boulevard NE
Suite324
Atlanta, GA 30312-1283
Phone
(404) 523-1864
Fax
(404) 521-9261
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61273322 WA
Internal Medicine Physician 207R00000X 0044779 GA Primary

Addresses

Primary practice location

340 Boulevard NE
Suite324
Atlanta, GA 30312-1283

Mailing address

PO Box 3032
Duluth, GA 30096-0052
Phone (678) 532-9044

Other practice location 1

14415 Front Beach Rd Unit 2002
Panama City Beach, FL 32413-0525
Phone (678) 907-6501

Other practice location 2

1016 Tacoma Ave
Sunnyside, WA 98944-2263
Phone (303) 390-1940

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL m.lyubich

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040913000292 GA Practitioner - Internal Medicine 4789651506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5575 DTC Pkwy
Suite 225
Greenwood Village, CO 80111-3012

5575 DTC Pkwy
Suite 225
Greenwood Village, CO 80111-3073

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0044779GAMDInternal Medicine Physician
MD61273322WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hightower Physician Services, PC CurrentSince Dec 3, 2021 Accepting new patients
L & H Internal Medicine PC Internal Medicine PastSince Feb 20, 1999 Accepting new patients
Sunnyside Community Hospital Association Past Accepting new patients

Locations

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

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.

Hospital & facility affiliations 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1558473256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3032",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300960052",
            "telephone_number": "678-532-9044",
            "fax_number": "404-521-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOULEVARD NE",
            "address_2": "SUITE324",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121283",
            "telephone_number": "404-523-1864",
            "fax_number": "404-521-9261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14415 Front Beach Rd Unit 2002",
            "address_purpose": "LOCATION",
            "city": "Panama City Beach",
            "state": "FL",
            "postal_code": "324130525",
            "country_code": "US",
            "telephone_number": "678-907-6501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 Tacoma Ave",
            "address_purpose": "LOCATION",
            "city": "Sunnyside",
            "state": "WA",
            "postal_code": "989442263",
            "country_code": "US",
            "telephone_number": "303-390-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYUBICH",
        "first_name": "MIKHAIL",
        "credential": "MD PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61273322",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "0044779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "m.lyubich",
            "affiliation": "N",
            "address_1": "14415 Front Beach Rd Unit 2002",
            "city": "Panama City Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324130525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.