Andrey Lutskovsky, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101016687 Issued in MI

Practice address

31000 Telegraph Rd
Ste. 140
Bingham Farms, MI 48025-4360

Phone

(248) 480-0895

Fax

(248) 480-0705

NPI assigned

Aug 9, 2007

Last updated

May 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

General PracticeAlso: Family Practice, Geriatric Medicine, Hospice/Palliative Care, Internal Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Croix Hospice Hospice, Troy, MI, CCN 231635
• St Croix Hospice Plymouth Hospice, Livonia, MI, CCN 231653

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• CS Mi Opco LLC

  dba St Croix Hospice Plymouth

  • Community Based Hospice Care Agency
  • Livonia, MI
  • NPI 1689304685

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

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.

• Better Care Company, PC

  • General Practice Physician
  • Bingham Farms, MI
  • NPI 1124441258

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Compassionate Doctors PC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1326153578
  NPD (past)
• Home VP Inc

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1922124320
  NPD (past)
• Ve Care, Inc

  • Home Health Agency
  • Pacifica, CA
  • NPI 1891262796
  NPD (past)

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

• CNS Hospice LLC

  dba St Croix Hospice

  • Community Based Hospice Care Agency
  • Troy, MI
  • NPI 1578830881
  Care Compare affiliation
• CS Mi Opco LLC

  dba St Croix Hospice Plymouth

  • Community Based Hospice Care Agency
  • Livonia, MI
  • NPI 1689304685
  Care Compare affiliation

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1932390317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "STE. 140",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-480-0895",
            "fax_number": "248-480-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "STE. 140",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-480-0895",
            "fax_number": "248-480-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTSKOVSKY",
        "first_name": "ANDREY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101016687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Lulgjuraj
• Nicolette Lulgjuraj
• Christopher Robert Lumley, D.O.
• Jonathan Lawrence Lundblad, MA
• Tyler Lusczki
• Lindsey Lyda
• Ashley Elizabeth Lynch
• Brigid Grace Lynch, MA, LPC
• Colleen Marie Lyon
• True Macdormott

• Internal Medicine Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.