Individual provider Active NPI

Sarah Lacy, MD

  • Pediatrics Physician
  • Plymouth, MI
National Provider Identifier
1811023617
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301081675 Issued in MI
Practice address
990 W Ann Arbor TRL Ste 210
Plymouth, MI 48170-6202
Phone
(734) 554-6004
Fax
(734) 455-5637
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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 4301081675 MI Primary

Addresses

Primary practice location

990 W Ann Arbor TRL Ste 210
Plymouth, MI 48170-6202

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 327-0872

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
I20170328000300 MI Practitioner - Pediatric Medicine 8729363122 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301081675MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Feb 22, 2017 Accepting new patients
Iha Health Services Corporation Pediatrics CurrentSince Feb 22, 2017 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

49650 Cherry Hill Rd
Ste 220
Canton, MI 48187
Phone (734) 398-7888

49650 Cherry Hill Rd
Ste 210
Canton, MI 48187
Phone (734) 398-7899

1600 S Canton Center Rd
Ste 200
Canton, MI 48188
Phone (734) 398-5229

990 W Ann Arbor Trl
Plymouth, MI 48170
Phone (313) 455-5990

990 W Ann Arbor Trl
Ste 210
Plymouth, MI 48170
Phone (734) 455-4600

Interoperability endpoints

  • Direct secure messaging: slacy40167@direct.trinity-health.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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1811023617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-327-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL STE 210",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706202",
            "telephone_number": "734-554-6004",
            "fax_number": "734-455-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "SARAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301081675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.