Lisa Allyn Manz Dulac, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

43010053049 Issued in MI

Practice address

20030 Mack Ave
Grosse Pointe Woods, MI 48236-2323

Phone

(313) 884-3380

Fax

(313) 884-9756

NPI assigned

Mar 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisa a Manz Dulac MD and Associates PCGroup PAC ID 4880666429, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

Merit-based Incentive Payment System (MIPS)

Final score

96.34 of 100Reported as group

Quality

90.86

Improvement activities

40

Cost

100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: lmanzdulac1140114@direct.hfhs.org

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.

• Lisa a Manz Dulac MD & Associates PC

  • Specialist
  • Grosse Pointe Woods, MI
  • NPI 1326007956
  Medicare reassignment Care Compare group Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1871552497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20030 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-884-3380",
            "fax_number": "313-884-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20030 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362323",
            "telephone_number": "313-884-3380",
            "fax_number": "313-884-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZ DULAC",
        "first_name": "LISA",
        "middle_name": "ALLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "43010053049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3491350",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendra K Malcolm
• Andrew Manardo, MS, CCC-SLP
• Toni Marie Mancini, PA-C
• Mary A Mandziara, NP
• Manor Pharmacy & Surgical Supply
• Marivic D. Massand MD,PLLC
• Danielle Marie Marken
• Pennie Marie Marko, CRNA
• Kayla Marlow
• Nathan E Maroney, LLPC

• Specialist in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.

Verify at the official NPI Registry.