MARK THOMAS VANDER LUGT (M.D.) – Pediatric Hematology & Oncology Physician, NPI 1861562985

MARK THOMAS VANDER LUGT (M.D.) is a healthcare provider. based in Ann arbor, Michigan. specializing in PEDIATRIC MEDICINE. They hold the professional credentials M.D.. They hold a License No. MD446513 (PA). The NPI Number for MARK THOMAS VANDER LUGT (M.D.) is 1861562985

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
MARK THOMAS VANDER LUGT (M.D.)
NPI
1861562985
Phone
(734) 936-2047
Address
3621 SOUTH STATE STREET
Enumeration Date
8 November 2006
Last Update Date
2 August 2016

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
7346478901
Graduation Year
2006 (20 years ago)
PAC ID
8921257189
Group Practice PAC ID
3779496856
Professional Enrollment ID
I20160727001356
Address ID
MI481090999AN1500XLEVE601
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,204 PEDIATRIC MEDICINE in MI

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Provider Addresses for MARK THOMAS VANDER LUGT (M.D.)

  • South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States

    700 KMS PLACE

    ANN ARBOR, MI 48108

    Phone: (734) 936-2047

    Type: Mailing

  • Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States

    7TH FLOOR C.S. MOTT CHILDRENS HOSPITAL

    ANN ARBOR, MI 481094257

    Phone: (734) 936-9814

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $813.

Total Amount is formed as General ($813) + Research ($0) + Ownership ($0) = $813.

Last reported payment date: 2024-10-17 • Largest payer in this snapshot: National Marrow Donor Program ($772).

Total Amount

$813

General + Research + Ownership

Payments

2

Total payment records

General Amount

$813

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-07-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20160727001356IPediatric MedicineMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48108)

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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: 3779496856View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YFL
Physical Medicine And RehabilitationMI
A N E S T H E S I O L O G YMI
Internal Medicine, Pediatric MedicineIL
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

Does MARK THOMAS VANDER LUGT (M.D.) have a public NPI I can cite?
Public records show MARK THOMAS VANDER LUGT (M.D.) under NPI 1861562985.
Is MARK THOMAS VANDER LUGT (M.D.)'s NPI status active today?
Active status means MARK THOMAS VANDER LUGT (M.D.)'s NPI record is not deactivated in the public file.
How should patients interpret MARK THOMAS VANDER LUGT (M.D.)'s specialty?
The extract shows Pediatric Hematology & Oncology Physician for MARK THOMAS VANDER LUGT (M.D.). Clinical services aligned with this taxonomy classification.
Is MARK THOMAS VANDER LUGT (M.D.) tied to Ann Arbor, Michigan?
If you are local to Ann Arbor, Michigan, MARK THOMAS VANDER LUGT (M.D.) may be relevant to your search.
Who maintains MARK THOMAS VANDER LUGT (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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