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EASTSIDE DERMATOLOGY PC
NPI 1326007956
Specialist in Grosse Pointe Woods, MI

Active since March 22, 2006CLIA 23D2295804 · Certificate of Compliance
20030 MACK AVE, GROSSE POINTE WOODS, MI 48236(313) 884-3380(313) 884-9756 Get Directions Write a Review

NPPES record last updated: January 3, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Eastside Dermatology Pc NPPES

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

EASTSIDE DERMATOLOGY PC (NPI 1326007956) is a healthcare organization registered as a specialist in Grosse Pointe Woods, Michigan and active in the NPI registry since March 2006. The organization holds a CLIA Certificate of Compliance certificate valid through December 16, 2026 and lists Lisa A Manz-dulac, Owner, as its authorized official.

NPPES Registry Identity

NPI1326007956
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLISA A MANZ DULAC MD & ASSOCIATES PC
Location Address20030 MACK AVEGrosse Pointe Woods, MI 48236-2323
Mailing Address20030 Mack AveGrosse Pointe Woods, MI 48236-2323 · (313) 884-3380 · Fax (313) 884-9756
Phone(313) 884-3380
Fax(313) 884-9756
Organization SubpartNo
Authorized OfficialLisa A Manz-dulacOwner · (313) 884-3380
Enumeration DateMarch 22, 2006
Last NPPES UpdateJanuary 3, 2012
✔ NPI 1326007956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
20030 MACK AVE, Grosse Pointe Woods, MI 48236
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Other Names 1

Doing Business AsEastside Dermatology Pc

Other Identifiers 3

Medicare ID-Type UnspecifiedOM75680MI · Medicare Group Number
Other070H24887MI · Bcbs Of Mi Group Number
Other23D0916007MI · Clia Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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)

Eastside Dermatology 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 Eastside Dermatology PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Natalia Filipof
Internal Medicine
NPI 1245340975
20030 MACK AVE
Grosse Pointe Woods, MI 48236
(313) 884-3380
✔ PECOS✔ Accepts MedicareSame address
Lisa Manz Dulac, MD
Dermatology
NPI 1871552497
20030 MACK AVE
Grosse Pointe Woods, MI 48236
(313) 884-3380
✔ PECOS✔ Accepts MedicareSame address
Kendall Rabaut, FNP-C
Nurse Practitioner
NPI 1093545857
20030 MACK AVE
Grosse Pointe Woods, MI 48236
(313) 884-3380
✔ PECOS✔ Accepts MedicareSame address
Douglas Piernick, M.D.
Dermatology
NPI 1487053575
20030 MACK AVE
Grosse Pointe Woods, MI 48236
(313) 884-3380
✔ PECOS✔ Accepts MedicareSame address
Danielle Bosscher, FNP-C
Nurse Practitioner
NPI 1871040154
511 PIERCE ST
Birmingham, MI 48009
(248) 693-0543
✔ PECOS✔ Accepts Medicare17 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 Compliance 23D2295804

Eastside Dermatology · New Baltimore, MI
Active · expires Dec 16, 2026
CLIA Number23D2295804
Laboratory TypePhysician Office
Certificate Effective DateDecember 17, 2024
Certificate Expiration DateDecember 16, 2026
Laboratory DirectorDouglas M. Piernick II
Laboratory Phone(313) 884-3380
Laboratory LocationEastside Dermatology32743 23 Mile Road Suite 230, New Baltimore, MI 48047
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Lisa A Manz Dulac MD & Associates PC's NPI number?

The NPI number for Lisa A Manz Dulac MD & Associates PC is 1326007956. It was assigned to this organization in the NPPES registry on March 22, 2006. The provider is doing business as Eastside Dermatology PC.

Where is Lisa A Manz Dulac MD & Associates PC located?

Lisa A Manz Dulac MD & Associates PC is located at 20030 Mack Ave, Grosse Pointe Woods, MI 48236. The listed phone number is (313) 884-3380.

What is Lisa A Manz Dulac MD & Associates PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Lisa A Manz Dulac MD & Associates PC enrolled in Medicare?

Yes. Lisa A Manz Dulac MD & Associates PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lisa A Manz Dulac MD & Associates PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Lisa A Manz Dulac MD & Associates PC, in Dermatology, Internal Medicine 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 at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lisa A Manz Dulac MD & Associates PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 23D2295804) is associated with this NPI, valid through December 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lisa A Manz Dulac MD & Associates 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 Lisa A Manz Dulac MD & Associates 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 Lisa A Manz Dulac MD & Associates PC was last updated on January 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.