Individual provider Active NPI

Lourdes Villalobos Andaya, MD

  • Neurology Physician
  • Detroit, MI
National Provider Identifier
1831274786
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
32565 Issued in MI
Practice address
4160 John R St
Suite 819
Detroit, MI 48201-2020
Phone
(313) 832-2880
Fax
(313) 832-7845
NPI assigned
Oct 26, 2006
Last updated
Aug 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 32565 MI Primary

Addresses

Primary practice location

4160 John R St
Suite 819
Detroit, MI 48201-2020

Mailing address

4160 John R St
Suite 819
Detroit, MI 48201-2020
Phone (313) 832-2880

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
I20100825000475 MI Practitioner - Neurology 5698808665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Grosse Pointe, MI 48230
Phone (313) 580-8487

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32565MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes V Andaya MD PC Neurology CurrentSince Jan 1, 2010 Accepting new patients

Locations

4160 John R St
Ste 819
Detroit, MI 48201
Phone (313) 832-2880

4160 John R St
Ste 624
Detroit, MI 48201
Phone (313) 832-2880

Interoperability endpoints

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1831274786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 819",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-832-2880",
            "fax_number": "313-832-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 819",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-832-2880",
            "fax_number": "313-832-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDAYA",
        "first_name": "LOURDES",
        "middle_name": "VILLALOBOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "32565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.