Individual provider Active NPI

Yash P Lakra, MD

  • Surgery Physician
  • Bloomfield Hills, MI
National Provider Identifier
1689694929
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
YL032210 Issued in MI
Practice address
4129 Golf Ridge Dr E
Bloomfield Hills, MI 48302-1728
Phone
(248) 855-1247
NPI assigned
Jul 20, 2006
Last updated
May 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X YL032210 MI Primary

Addresses

Primary practice location

4129 Golf Ridge Dr E
Bloomfield Hills, MI 48302-1728

Mailing address

4129 Golf Ridge Dr E
Bloomfield Hills, MI 48302-1728
Phone (248) 855-1247

Other identifiers 3

IdentifierTypeStateIssuer
C2555OtherMCARE
0206312361OtherBCBS
1361132MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
YL032210MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pontiac General Hospital and Medical Centers PastSince Jun 10, 2004 Accepting new patients
Vitality Group Inc PastSince Mar 30, 2014 Accepting new patients
Embrace Home Physicians PLLC PastSince Nov 21, 2016 Accepting new patients
Professional Primary Care Services PC Past Accepting new patients
RTC Enterprise, Inc. Past Accepting new patients

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, 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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1689694929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 GOLF RIDGE DR E",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021728",
            "telephone_number": "248-855-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 GOLF RIDGE DR E",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021728",
            "telephone_number": "248-855-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKRA",
        "first_name": "YASH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "YL032210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C2555",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0206312361",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1361132",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.