ASCENSION MEDICAL GROUP MICHIGAN (NPI# 1174537500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174537500 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP MICHIGAN |
| Practice Address |
2800 Livernois Rd Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 2486808000 |
| Practice Fax Number | 2486808208 |
| Mailing Telephone | 2486808000 |
| Mailing Fax Number | 2486808208 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-03-22 |
| Authorized Official Name | MARTHA JOHNSON (DIRECTOR) |
| Authorized Official Telephone | 2486808004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
MI | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | MI | Allopathic & Osteopathic Physicians | |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MI | Allopathic & Osteopathic Physicians | |
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
MI | Allopathic & Osteopathic Physicians | |
| N | 207V00000X | Obstetrics & Gynecology | MI | Allopathic & Osteopathic Physicians | |
| N | 207W00000X | Ophthalmology | MI | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | MI | Allopathic & Osteopathic Physicians | |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MI | Allopathic & Osteopathic Physicians | |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
MI | Allopathic & Osteopathic Physicians | |
| N | 208600000X | Surgery | MI | Allopathic & Osteopathic Physicians | |
| N | 208D00000X | General Practice | MI | Allopathic & Osteopathic Physicians | |
| N | 208M00000X | Hospitalist | MI | Allopathic & Osteopathic Physicians | |
| N | 363A00000X | Physician Assistant | MI | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM GROUP # | 700E012740 | 01 |
| MI | RAILROAD MEDICARE GROUP NUMBER | CG3113 | 01 |
| MI | RAILROAD MEDICARE GROUP NUMBER | CG4684 | 01 |
| MI | RAILROAD MEDICARE GROUP NUMBER | CG4683 | 01 |
| MI | BCBS GROUP NUMBER - SHORES DX | 0E02084 | 01 |
| MI | RAILROAD MEDICARE GROUP NUMBER | CB2735 | 01 |
| MI | BCBS GROUP NUMBER - ROMEO PLANK DX | 0E02208 | 01 |
| MI | RAILROAD MEDICARE GROUP NUMBER | CA6965 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801992557 | Ascension Medical Group Michigan | Podiatrist | 13935 Plumbrook Rd, Sterling Heights, MI 48312-1727 | 2006-09-16 |
| 1770984601 | Ascension Medical Group Michigan | Clinical Medical Laboratory | 19229 Mack Ave, Suite 27, Grosse Pointe Woods, MI 48236-2858 | 2014-09-10 |
| 1871913228 | Ascension Medical Group Michigan | Clinical Medical Laboratory | 1901 Star Batt Dr, Rochester Hills, MI 48309-3712 | 2014-04-24 |
| 1851732226 | Ascension Medical Group Michigan | Family Medicine | 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 | 2013-07-12 |
| 1316197502 | Ascension Medical Group Michigan | Internal Medicine | 2033 Crooks Rd, Royal Oak, MI 48073-4049 | 2008-09-24 |
| 1548433626 | Ascension Medical Group Michigan | Surgery | 4014 River Rd, 3b, East China, MI 48054-2916 | 2008-04-09 |
| 1629272968 | Ascension Medical Group Michigan | Dentist | 22201 Moross Rd, Detroit, MI 48236-2169 | 2007-06-12 |
| 1730380254 | Ascension Medical Group Michigan | Family Medicine | 37771 Schoenherr Rd, Suite 104, Sterling Heights, MI 48312-2302 | 2007-05-31 |
| 1114133485 | Ascension Medical Group Michigan | Pediatrics | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2007-05-15 |
| 1144436411 | Ascension Medical Group Michigan | Nurse Practitioner | 42645 Garfield Rd, Clinton Township, MI 48038-5022 | 2007-05-15 |
| Street Address |
2800 LIVERNOIS RD SUITE 500 |
| City | TROY |
| State | MI |
| Zip Code | 48083-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093776 | Ascension Providence Hospital | Nuclear Medicine | 2800 Livernois Rd, Blgd D Suite 500, Troy, MI 48083-1215 | 2006-04-19 |
| 1851765374 | Ascension Michigan-cmg | Family Medicine | 2800 Livernois Rd, Bldg E Suite 275, Troy, MI 48083-1215 | 2015-11-20 |
| 1598177065 | Seton Health Corporation of Southeastern Michigan | Internal Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2014-06-02 |
| 1720390453 | Ascension Macomb Oakland Hospital | Internal Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-10 |
| 1457663197 | Ascension St John Hospital | Family Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-10 |
| 1376854661 | St. John Hospital and Medical Center | Nurse Practitioner | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-01 |
| 1114133485 | Ascension Medical Group Michigan | Pediatrics | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2007-05-15 |
| 1376644922 | Ascension Medical Group Michigan | Family Medicine | 2800 Livernois Rd, Troy, MI 48083-1215 | 2006-09-26 |
| 1942317631 | Ascension Medical Group Michigan | Obstetrics & Gynecology | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2006-08-25 |
| 1730117805 | Ascension Medical Group Michigan | Family Medicine | 2800 Livernois Rd, Troy, MI 48083-1215 | 2006-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376159327 | Charity Jan Martin | Family Medicine | 507 Ellis Ave, Troy, TX 76579-2515 | 2020-09-16 |
| 1871123844 | Tangerine Health Inc. | Family Medicine | 1432 Devon Ln, Troy, MI 48084-7046 | 2020-01-18 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1861982423 | Omni Wellness Group LLC | Family Medicine | 1149 Experiment Farm Road, Troy, OH 45373 | 2018-05-18 |
| 1952830432 | Fhpg, LLC | Family Medicine | 522 Allen St Ste 203, Troy, NC 27371-2861 | 2017-06-08 |
| 1144583832 | Norah Duncan | Family Medicine | 2041 E Square Lake Rd., Suite 300, Troy, MI 48085 | 2012-06-19 |
| 1740590231 | Bhavesh Patel | Family Medicine | 619 Edwardsville Rd, Troy, IL 62294-1441 | 2010-10-18 |
| 1427289081 | Ghidah Edmon Al-khouri | Family Medicine | 627 E Maple Rd Ste 200, Troy, MI 48083-2812 | 2009-07-30 |
| 1245467224 | Anne S Pamula | Family Medicine | 68 Fenner Ave, Troy, Troy, PA 16947-1501 | 2009-06-17 |
| 1831362425 | Michael Saad Mitry | Family Medicine | 3661 Wakefield Dr, Troy, MI 48083-5358 | 2008-04-04 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.