Individual provider Active NPI

Jorge Lim Lua, MD

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1700823366
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301069523 Issued in MI
Practice address
Childrens Hospital Mi Neonatology
3901 Beaubien 2ND Floor - Main Building
Detroit, MI 48201
Phone
(313) 745-1436
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301069523 MI Primary

Addresses

Primary practice location

Childrens Hospital Mi Neonatology
3901 Beaubien 2ND Floor - Main Building
Detroit, MI 48201

Mailing address

3800 Woodward Ave
Suite 702
Detroit, MI 48201-2061

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
I20051117000753 MI Practitioner - Pediatric Medicine 0446279533 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Sep 29, 2010 Accepting new patients
University Pediatricians Pediatrics CurrentSince Sep 29, 2010 Accepting new patients
VHS Childrens Hospital of Michigan Inc Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

4201 Saint Antoine St
Ste 226
Detroit, MI 48201
Phone (313) 966-2064

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3901 Beaubien St
Fl 3
Detroit, MI 48201
Phone (313) 745-5906

Interoperability endpoints

  • Direct secure messaging: jlua@direct.dmc.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1700823366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 702",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDRENS HOSPITAL MI NEONATOLOGY",
            "address_2": "3901 BEAUBIEN 2ND FLOOR - MAIN BUILDING",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUA",
        "first_name": "JORGE",
        "middle_name": "LIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301069523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.