NPIMap

Organization Active NPI

Oakland Integrated Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pontiac, MI
National Provider Identifier
1962765529
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OAKLAND INTEGRATED HEALTHCARE NETWORK
Practice address
114 Orchard Lake
Pontiac, MI 48341-2244
Phone
(248) 724-7605
Fax
(248) 636-4043
NPI assigned
Jun 19, 2012
Organization subpart
Yes
Parent organization
OAKLAND INTEGRATED HEALTHCARE NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Authorized official

Name
Mrs. Debra Lustig
Title
Ceo
Phone
(248) 724-7438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

114 Orchard Lake
Pontiac, MI 48341-2244

Mailing address

P.O. Box 430150
Pontiac, MI 48343
Phone (248) 724-7600

Other names 1

  • OIHN - Orchard Lake Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120611000523 MI Part B Supplier - Clinic/Group Practice 9436313004 Receives reassigned benefits from 47 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pontiac, MI; Waterford, MI; Southfield, MI
O20130809000507 MI Part A Provider - Federally Qualified Health Center (FQHC) 9436313004 Practice locations: Pontiac, MI

Federally qualified health center certification: CCN 231019

Legal name
OAKLAND INTEGRATED HEALTHCARE NETWORK
Doing business as
OIHN ORCHARD LAKE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 23, 2013
Last certification
Sep 23, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 18, 2012 in MI
Enrollment address
114 Orchard Lake Rd
Pontiac, MI 48341-2244

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Oakland Integrated Network24 organizations share this tax ID, including this one
Part of
Oakland Integrated Network

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melissa M McQueen Individual W-2 Managing EmployeeDirector, Revenue Cycle Nov 2, 2016
Charlotte Richardson Individual OtherDirector Jan 1, 2014
Barbara Belkiewicz Individual Operational/Managerial ControlBoard Member Sep 13, 2021
Michael Robinson Individual OtherDirector Jan 1, 2014
Debra Brinson Individual Corporate OfficerCeo Jan 1, 2014
Debra Geroux Individual OtherDirector Jan 1, 2014
Rick David Individual OtherDirector Jan 1, 2014
Laurie Horvath Individual OtherDirector Jan 1, 2014
Barbara Knight Individual OtherVice Chairperson Jan 1, 2014
Merlyn Parra Individual OtherSecretary Jan 1, 2014
Michael Yocum Individual OtherTreasurer Jan 1, 2014
Nikhil K Hemady Individual Corporate DirectorMedical Director Aug 30, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1962765529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 430150",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48343",
            "telephone_number": "248-724-7600",
            "fax_number": "248-636-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-724-7605",
            "fax_number": "248-636-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND INTEGRATED HEALTHCARE NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLAND INTEGRATED HEALTHCARE NETWORK",
        "enumeration_date": "2012-06-19",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "LUSTIG",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-724-7438",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OIHN - Orchard Lake Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.