LISA LECLAIR (NP) – Nurse Practitioner, NPI 1104399880

LISA LECLAIR (NP) is a healthcare provider. based in Flushing, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 4704220646 (MI). The NPI Number for LISA LECLAIR (NP) is 1104399880

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
LISA LECLAIR (NP)
NPI
1104399880
Phone
(810) 659-5525
Address
6267 DUFFIELD RD
Enumeration Date
6 January 2019
Last Update Date
3 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6165310200
Graduation Year
2018 (8 years ago)
PAC ID
1557604493
Group Practice PAC ID
2163798877
Professional Enrollment ID
I20190516002961
Address ID
MI495094004WY625XXSWXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:7State licenses:2Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for LISA LECLAIR (NP)

  • 6267 DUFFIELD RD

    FLUSHING, MI 484339264

    Phone: (810) 659-5525

    Type: Location

  • 6267 Duffield Rd

    Flushing, MI 484339264

    Phone: (810) 659-5525

    Type: Location

  • 39465 W 14 Mile Rd

    Novi, MI 483771600

    Phone: (877) 906-9699

    Fax: (888) 483-0118

    Type: Location

  • 993 45TH ST

    MANGONIA PARK, FL 334072413

    Phone: (561) 257-3348

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-11-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190516002961INurse PractitionerMITBD
I20220210001549INurse PractitionerFLTBD
I20220215001771INurse PractitionerTNTBD
I20221128002811INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes856261$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes694217$0
99316Nursing facility discharge management, more than 30 minutes6665$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes2214$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes1312$0
View full utilization report →

Insurance plans in this area (ZIP 48433)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163798877View full group profile

Reviews

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Frequently asked questions

Can I cross-check LISA LECLAIR (NP) using NPI 1104399880?
NPI 1104399880 belongs to LISA LECLAIR (NP); compare other details if you need extra assurance.
Active or inactive — what applies to LISA LECLAIR (NP)?
You should see LISA LECLAIR (NP) as active in CMS-hosted NPPES data.
What clinical focus is listed for LISA LECLAIR (NP)?
At a glance, LISA LECLAIR (NP) is tied to Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Michigan is LISA LECLAIR (NP) registered?
Use Flushing, Michigan as the headline location for LISA LECLAIR (NP) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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