Stephanie A. Lusis, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704097964 Issued in MI

Practice address

3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712

Phone

(248) 423-2454

Fax

(248) 423-2576

NPI assigned

Jul 30, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• William Beaumont Hospital

  dba Beaumont Clinical Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1639226699
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881609584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "FSC",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-423-2454",
            "fax_number": "248-423-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "FSC",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-423-2454",
            "fax_number": "248-423-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSIS",
        "first_name": "STEPHANIE",
        "middle_name": "A.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704097964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4578715",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jovani Lulgjuraj, PHARMD
• Lumnora Counseling Services PLLC
• Thomas Lundblad, CRNA
• Ali Luqman, MD
• Jillian Joyce Lusardi, CRNA
• Amanda Luteran, LLPC
• Kathryn Lutz, PHARMD
• Katherine Mary Lynch, AU.D
• Kelly Lynch
• Jacob Ryan Lynn, P.A.

• Gerontology Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.