Active NPI
Laurie Diane Donaldson, MD
- Pediatric Sports Medicine Physician
- Ann Arbor, MI
National Provider Identifier
1720189632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Sports Medicine Physician
- License
- 4301086674
- Practice address
- 24 Frank Lloyd Wright Dr
Lobby a
Ann Arbor, MI 48105-9484 - Phone
- (734) 930-7400
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301086674 | MI | |
| Pediatric Sports Medicine Physician | 2080S0010X | 4301086674 | MI | Primary |
Addresses
Primary practice location
24 Frank Lloyd Wright Dr
Lobby a
Ann Arbor, MI 48105-9484
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4828620 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ldonaldson99250@direct.beaumont.edu |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- University of Missouri, Columbia School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
25631 Little Mack Ave
Lowr Level
Saint Clair Shores, MI 48081-2100
Phone (586) 443-2998
28100 Grand River Ave
Farmington Hills, MI 48336-5970
Hospital & facility affiliations
- Beaumont Hospital - Grosse Pointe
- Beaumont Hospital Royal Oak
- Beaumont Hospital, Troy
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301086674 | MI | MD | Pediatric Sports Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William Beaumont Hospital | Current | Accepting new patients | |
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients | |
| William Beaumont Hospital | Current | Accepting new patients | |
| William Beaumont Hospital | Current | Accepting new patients | |
| William Beaumont Hospital | Past | Accepting new patients |
Locations
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
26001 Jefferson Ave
Saint Clair Shores, MI 48081
Phone (586) 779-7000
25631 Little Mack Ave
Ste 102
Saint Clair Shores, MI 48081
Phone (586) 443-2317
Interoperability endpoints
- ldonaldson1231649@epic00.shdirect.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.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1811044878
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
-
- Physician Assistant
- Royal Oak, MI
- NPI 1164471983
Hospital & facility affiliations 4
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": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1720189632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DR",
"address_2": "LOBBY A",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484",
"telephone_number": "734-930-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALDSON",
"first_name": "LAURIE",
"middle_name": "DIANE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301086674",
"primary": false
},
{
"code": "2080S0010X",
"taxonomy_group": "",
"desc": "Pediatrics, Sports Medicine",
"state": "MI",
"license": "4301086674",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4828620",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ldonaldson99250@direct.beaumont.edu",
"affiliation": "N",
"address_1": "24 Frank Lloyd Wright Dr",
"address_2": "Lobby A",
"city": "Ann Arbor",
"state": "MI",
"country_code": "US",
"postal_code": "481059484",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.