Active NPI
David T Lujan, DO
- Psychiatry Physician
- Saint Clair Shores, MI
National Provider Identifier
1912088691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DL0127002
- Practice address
- 19900 10 Mine Road
Ste 102
St Clair Shores, MI 48080 - Phone
- (586) 776-3366
- Fax
- (586) 776-3366
- NPI assigned
- Oct 18, 2006
- Last updated
- Oct 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 5101012702 | MI | |
| Psychiatry Physician | 2084P0800X | DL0127002 | MI | Primary |
Addresses
Primary practice location
19900 10 Mine Road
Ste 102
St Clair Shores, MI 48080
Mailing address
19900 10 Mile Road
Ste 102
St Clair Shores, MI 48080
Phone (586) 776-3366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101012702 | MI | MD | Psychiatry Physician |
| DL0127002 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Macomb Family Services, Inc | Psychiatry | Past | Accepting new patients |
| Counseling Associates Inc | Past | Accepting new patients | |
| Carol a. Roekle, M.D., P.C. | Past | Accepting new patients | |
| Macomb Family Services, Inc. | Psychiatry | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/macombfamily/r4/
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Farmington Hills, MI
- NPI 1659419257
-
- Mental Health Counselor
- West Bloomfield, MI
- NPI 1629069471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350950400000",
"number": "1912088691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19900 10 MILE ROAD",
"address_2": "STE 102",
"city": "ST CLAIR SHORES",
"state": "MI",
"postal_code": "48080",
"telephone_number": "586-776-3366",
"fax_number": "586-776-3369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19900 10 MINE ROAD",
"address_2": "STE 102",
"city": "ST CLAIR SHORES",
"state": "MI",
"postal_code": "48080",
"telephone_number": "586-776-3366",
"fax_number": "586-776-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUJAN",
"first_name": "DAVID",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2012-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "5101012702",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "DL0127002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.