Individual provider Active NPI

Lucien Tamer, M.D.

  • Psychiatry Physician
  • Holland, MI
National Provider Identifier
1760655195
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301097757 Issued in MI
Practice address
854 Washington Ave
Suite 330
Holland, MI 49423-7144
Phone
(616) 355-3926
Fax
(616) 393-6651
NPI assigned
Apr 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 001559 GA
Psychiatry Physician 2084P0800X 4301097757 MI Primary

Addresses

Primary practice location

854 Washington Ave
Suite 330
Holland, MI 49423-7144

Mailing address

5710 Saint Joseph Ave
Stevensville, MI 49127-1240
Phone (269) 281-3994

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
I20110308000323 MI Practitioner - Psychiatry 8820270192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berrien Mental Health AuthorityGroup PAC ID 0345223707, 20 clinicians

Practice addresses (Care Compare)

1485 M
Suite 139
Benton Harbor, MI 49022-5711
Phone (269) 934-1611

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001559GAMDClinical Child & Adolescent Psychologist
4301097757MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Feb 1, 2016 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Aug 1, 2017 Accepting new patients
Lakeland Medical Practices CurrentSince Feb 1, 2016 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Aug 1, 2017 Accepting new patients
Psychiatric and Psychological Specialties PastSince May 14, 2023 Accepting new patients

Locations

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Organizations & group practices 6

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 1

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": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1760655195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 SAINT JOSEPH AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491271240",
            "telephone_number": "269-281-3994",
            "fax_number": "269-588-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE",
            "address_2": "SUITE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237144",
            "telephone_number": "616-355-3926",
            "fax_number": "616-393-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMER",
        "first_name": "LUCIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-07",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "001559",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301097757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.