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CENTER FOR PREVENTIVE MEDICINE PC
NPI 1174719025
Internal Medicine in Grosse Pointe Woods, MI

Active since September 24, 2007CLIA 23D0370914 · Waiver
20870 MACK AVE, GROSSE POINTE WOODS, MI 48236(313) 885-2334(313) 647-4837 Get Directions Write a Review

NPPES record last updated: May 4, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Center For Preventive Medicine Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTER FOR PREVENTIVE MEDICINE PC (NPI 1174719025) is a healthcare organization registered as an internal medicine in Grosse Pointe Woods, Michigan and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through June 10, 2027 and lists Stephenie Lucas, Owner, as its authorized official.

NPPES Registry Identity

NPI1174719025
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTER FOR PREVENTIVE MEDICINE PC
Location Address20870 MACK AVEGrosse Pointe Woods, MI 48236-1388
Mailing Address20870 Mack AveGrosse Pointe Woods, MI 48236-1388 · (313) 885-2334 · Fax (313) 647-4837
Phone(313) 885-2334
Fax(313) 647-4837
Organization SubpartNo
Authorized OfficialStephenie LucasOwner · (313) 885-2334
Enumeration DateSeptember 24, 2007
Last NPPES UpdateMay 4, 2017
✔ NPI 1174719025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X
Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X
20870 MACK AVE, Grosse Pointe Woods, MI 48236
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Other Identifiers 1

Medicare PIN0N62180MI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Center For Preventive Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Center For Preventive Medicine PC, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Logan Oney, MD
Internal Medicine
NPI 1740397207
22631 GREATER MACK AVE. SUITE 100
St Clair Shores, MI 48080
(313) 885-2334
✔ PECOS1.0 mi
Stephenie Lucas, M.D.
Internal Medicine
NPI 1023116068
22631 GREATER MACK AVE SUITE 100
Saint Clair Shores, MI 48080
(586) 771-0100
✔ PECOS✔ Accepts Medicare1.1 mi
Jennifer Kulinski, FNP-BC
Nurse Practitioner
NPI 1033595749
24800 URSULINE ST
Saint Clair Shores, MI 48080
(586) 945-5088
✔ PECOS✔ Accepts Medicare2.2 mi
Vamshidhar Guduguntla, MD
Interventional Cardiology
NPI 1174525729
25195 KELLY RD SUITE A
Roseville, MI 48066
(586) 775-4594
✔ PECOS✔ Accepts Medicare2.7 mi
Ann Marie Gabrielson, RN-NP
Nurse Practitioner
NPI 1861825242
3902 MONROE ST
Dearborn Heights, MI 48125
(313) 562-1985
✔ PECOS21 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0370914

Center For Preventive Medicine · Grosse Pointe, MI
Active · expires Jun 10, 2027
CLIA Number23D0370914
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2025
Certificate Expiration DateJune 10, 2027
Laboratory DirectorStephenie M. Lucas
Laboratory Phone(313) 885-2334
Laboratory LocationCenter For Preventive Medicine20870 Mack Avenue, Grosse Pointe, MI 48236
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Center For Preventive Medicine PC's NPI number?

The NPI number for Center For Preventive Medicine PC is 1174719025. It was assigned to this organization in the NPPES registry on September 24, 2007.

Where is Center For Preventive Medicine PC located?

Center For Preventive Medicine PC is located at 20870 Mack Ave, Grosse Pointe Woods, MI 48236. The listed phone number is (313) 885-2334.

What is Center For Preventive Medicine PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Center For Preventive Medicine PC enrolled in Medicare?

Yes. Center For Preventive Medicine PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Center For Preventive Medicine PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Center For Preventive Medicine PC, in Internal Medicine, Interventional Cardiology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Center For Preventive Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0370914) is associated with this NPI, valid through June 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Center For Preventive Medicine PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Center For Preventive Medicine PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Center For Preventive Medicine PC was last updated on May 4, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.