ASCENSION MEDICAL GROUP MICHIGAN (NPI# 1629272968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629272968 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP MICHIGAN |
| Practice Address |
22201 Moross Rd Detroit MI 48236-2169 |
| Mailing Address |
2800 Livernois Rd 500 Troy MI 48083-1215 |
| Practice Telephone | 2486808205 |
| Practice Fax Number | 2486808205 |
| Mailing Telephone | 2486808205 |
| Mailing Fax Number | 2486808205 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | ROBERT GUHA (VP FINANCE) |
| Authorized Official Telephone | 2486808264 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
MI | Allopathic & Osteopathic Physicians | |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | MI | Allopathic & Osteopathic Physicians | |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
MI | Allopathic & Osteopathic Physicians | |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MI | Allopathic & Osteopathic Physicians | |
| Y | 208600000X | Surgery | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS GROUP | 0H231320 | 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 |
| 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 |
| 1588737266 | Ascension Medical Group Michigan | Pediatrics | 46591 Romeo Plank Rd, Suite 205, Macomb, MI 48044-5742 | 2006-11-17 |
| Street Address |
22201 MOROSS RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760688 | Henry Grady Bone IIi | Internal Medicine | 22201 Moross Rd, Ste 260, Detroit, MI 48236-2175 | 2005-06-16 |
| 1790302396 | Zoheb Backer | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-30 |
| 1003432816 | Keerthana Reddy Banala | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 80, Detroit, MI 48236 | 2020-06-18 |
| 1013533918 | Sajithaa Varadarasa | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-17 |
| 1578188918 | Rida Jamal | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Detroit, MI 48236 | 2020-06-11 |
| 1669097952 | Inderpal Singh | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-11 |
| 1376168732 | Mehdi Yavari | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Detroit, MI 48236 | 2020-06-11 |
| 1548884414 | Krishna Chandra Mahat | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-05 |
| 1508358540 | Vito Saracino | Internal Medicine | 22201 Moross Rd, Detroit, MI 48236-2169 | 2018-06-05 |
| 1457880718 | Marco Antonio Martinez | Obstetrics & Gynecology | 22201 Moross Rd, Suite 370, Detroit, MI 48236 | 2017-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366881096 | Jennifer Ashley Cirino | Surgery | 2799 W Grand Blvd # 126, Detroit, MI 48202-2689 | 2013-06-15 |
| 1073856035 | Asra Hashmi | Surgery | 4201 St.antoine Street, 6c, Uhc, Detroit, MI 48201 | 2013-03-28 |
| 1396086997 | Ryan E Shelden | Surgery | 6001 West Outer Drive, Detroit, MI 48235 | 2013-03-06 |
| 1598029985 | Uzma Naim | Surgery | 200 Riverfront Dr, Apt 23c, Detroit, MI 48226-4525 | 2012-06-29 |
| 1336435494 | Inna Neyman Lobeck | Surgery | 4201 St. Antoine, 6c-university Health Center, Department of Surgery, Wayne State University, Detroit, MI 48201 | 2011-06-27 |
| 1235434770 | Amer Ali Almohssen | Surgery | 4201 St. Antoine, 6th Floor, 313-577-5013, Detroit, MI 48201 | 2011-01-13 |
| 1407166432 | Majid Toseef Aized | Surgery | 9c,4201 St. Antoine Blvd, Graduate Medical Education,detroit Receiving Hospital, Detroit, MI 48201 | 2010-10-08 |
| 1104067552 | Furrukh Jabbar | Surgery | 1 St Antoine Street, Detroit Receiving Hospital, Detroit, MI 48201 | 2009-03-16 |
| 1497995641 | Todd Thornton Lavery | Surgery | 4160 John R St Ste 615, Detroit, MI 48201-2022 | 2009-03-01 |
| 1982851028 | Kaushik Mandal | Surgery | 6001 W Outer Dr Ste 300, Detroit, MI 48235-2626 | 2008-08-20 |
| Find all providers in DETROIT | ||||
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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.