ASCENSION PROVIDENCE HOSPITAL (NPI# 1225093776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225093776 |
| Entity Type | Organization |
| Organization Name | ASCENSION PROVIDENCE HOSPITAL |
| Other Organization Name | PH EKG READS |
| Practice Address |
2800 Livernois Rd Blgd D Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 2486808091 |
| Mailing Telephone | 2486808091 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2018-12-04 |
| Authorized Official Name | SARAH STARKEL (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2486808121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MI BLUE CROSS GROUP PIN # | 240F370640 | 01 |
| Other Name | Type Code |
|---|---|
| PH EKG reads | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003892092 | Ascension Providence Hospital | Psychiatric Unit | 16001 W. 9 Mile Road, Southfield, MI 48075-4818 | 2005-12-21 |
| 1043385909 | Ascension Providence Hospital | General Acute Care Hospital | 47601 Grand River Ave, Novi, MI 48374-1233 | 2006-11-22 |
| 1851339196 | Ascension Providence Hospital | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-06-02 |
| 1003871062 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1629033683 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1265497226 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1619932670 | Ascension Providence Hospital | Psychiatry & Neurology | 16001 W 9 Mile Rd, Physician Billing Services, Southfield, MI 48075-4818 | 2006-04-20 |
| 1528023587 | Ascension Providence Hospital | Psychologist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1235194291 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1144285107 | Ascension Providence Hospital | General Practice | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| Street Address |
2800 LIVERNOIS RD BLGD D SUITE 500 |
| City | TROY |
| State | MI |
| Zip Code | 48083-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1174537500 | Ascension Medical Group Michigan | Family Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2006-07-28 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972051530 | Michael Abdul-malek Do Pllc | Internal Medicine | 1380 Coolidge Hwy Ste 250, Troy, MI 48084-7067 | 2016-09-13 |
| 1104125756 | Ibin Sina Cardiovascular Center PC | Internal Medicine | 2678 Melcombe Cir, 104, Troy, MI 48084-3457 | 2011-03-22 |
| 1891946703 | Ruslan Feygin | Internal Medicine | 2231 Burdett Ave Ste 160, Capital Cardiology Associates PC, Troy, NY 12180-2453 | 2008-10-09 |
| 1124187307 | Vina R. Patel | Internal Medicine | 763 Hoosick Road, Troy, NY 12180-6646 | 2006-12-06 |
| 1154422236 | Hussain A Khawaja | Internal Medicine | 258 Hoosick St Ste 107, Tri-city Cardiology Care, Pllc, Troy, NY 12180-2471 | 2006-09-25 |
| 1255371605 | Scott Jeffrey Denardo | Internal Medicine | 522 Allen St Ste 101, Troy, NC 27371-2861 | 2006-06-07 |
| 1487615241 | Rodrigo G Goh | Internal Medicine | 172 Professional Parkway, Po Box A, Troy, MO 63379-1520 | 2006-03-31 |
| 1104898667 | Maria Theresa Pacis Biederman | Internal Medicine | 3310 W Big Beaver Rd, Suite 137, Troy, MI 48084-2809 | 2006-02-07 |
| 1366420069 | Elizabeth Renukarani Claudius | Internal Medicine | 522 Allen St, Suite 101, Troy, NC 27371-2861 | 2006-01-04 |
| 1033192083 | Renato G Ramos | Internal Medicine | 1559 W Big Beaver Rd, Ste E, Troy, MI 48084-3525 | 2005-11-23 |
| 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.