Individual provider Active NPI

Lessa Azniv Dubay, OTR

  • Occupational Therapist
  • Macomb, MI
National Provider Identifier
1689846628
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201006047 Issued in MI
Practice address
17022 Country Club Dr
Macomb, MI 48042-1137
Phone
(586) 556-0378
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201006047 MI Primary

Addresses

Primary practice location

17022 Country Club Dr
Macomb, MI 48042-1137

Mailing address

17022 Country Club Dr
Macomb, MI 48042-1137
Phone (586) 556-0378

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldubay268685@direct.hfhs.org Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201006047MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1689846628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17022 COUNTRY CLUB DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480421137",
            "telephone_number": "586-556-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17022 COUNTRY CLUB DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480421137",
            "telephone_number": "586-556-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBAY",
        "first_name": "LESSA",
        "middle_name": "AZNIV",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldubay268685@direct.hfhs.org",
            "affiliation": "N",
            "endpointDescription": "ldubay268685@direct.hfhs.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.