Individual provider Active NPI

Vincent Alexander Lizzio

  • Orthopaedic Surgery Physician
  • Detroit, MI
National Provider Identifier
1659876993
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301512314 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2689
Phone
(313) 916-7520
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Orthopaedic Surgery Physician 207X00000X 4301512314 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2689

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2689
Phone (313) 916-7520

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
I20240626003285 MI Practitioner - Orthopedic Surgery 4284980814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610
Phone (313) 640-1000

19401 Hubbard Dr
Dearborn, MI 48126-2641
Phone (313) 916-2600

2799 W Grand Blvd
Detroit, MI 48202-2608

40777 Ann Arbor Rd E
Henry Ford Health Ortho Hand Spec
Plymouth, MI 48170-4448
Phone (734) 928-1600

6773 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6100

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6470

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301512314MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jun 17, 2024 Accepting new patients
Henr Y Ford Health System Orthopaedic Surgery CurrentSince Jun 17, 2024 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

690 Amsterdam St
Detroit, MI 48202
Phone (313) 623-2109

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

Interoperability endpoints

  • Direct secure messaging: vlizzio361909@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1659876993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZZIO",
        "first_name": "VINCENT",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301512314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.