Individual provider Active NPI

Lisa Anne Nemes, MD

  • Pediatrics Physician
  • Bloomfield Hills, MI
National Provider Identifier
1871087577
Registry record updated May 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301115202 Issued in MI
Practice address
1245 Robson LN
Bloomfield Hills, MI 48304-1536
Phone
(248) 909-0648
NPI assigned
Jun 18, 2018
Last updated
May 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4351028274 MI
Pediatrics Physician 208000000X 4301115202 MI Primary

Addresses

Primary practice location

1245 Robson LN
Bloomfield Hills, MI 48304-1536

Mailing address

1245 Robson LN
Bloomfield Hills, MI 48304-1536
Phone (248) 909-0648

Other names 1

  • Dr. Lisa Anne Vitello Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lisa.vitello@beaumont.org Direct

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
I20220309000872 MI Practitioner - Pediatric Medicine 2365798683 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351028274MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Pediatrics CurrentSince Dec 8, 2021 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Dec 8, 2021 Accepting new patients
St Joseph Mercy Hospital-SMHC Past Accepting new patients

Locations

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

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

Interoperability endpoints

  • Direct secure messaging: lisa.vitello@beaumont.org
  • Direct secure messaging: lnemes1766991@direct.trinity-health.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622246400000",
    "number": "1871087577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 ROBSON LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041536",
            "telephone_number": "248-909-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 ROBSON LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041536",
            "telephone_number": "248-909-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMES",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-05-29",
        "certification_date": "2021-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4351028274",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301115202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.vitello@beaumont.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3535 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "VITELLO",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.