ASCENSION MACOMB OAKLAND HOSPITAL (NPI# 1720390453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720390453 |
| Entity Type | Organization |
| Organization Name | ASCENSION MACOMB OAKLAND HOSPITAL |
| Other Organization Name | MEDICAL RESOURCES GROUP |
| Practice Address |
2800 Livernois Rd Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 2486808000 |
| Practice Fax Number | 2486808031 |
| Mailing Telephone | 2486808000 |
| Mailing Fax Number | 2486808031 |
| Enumeration Date | 2010-07-10 |
| 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 | 207R00000X | Internal Medicine | MI | Allopathic & Osteopathic Physicians | |
| N | 207W00000X | Ophthalmology | MI | Allopathic & Osteopathic Physicians | |
| N | 207X00000X | Orthopaedic Surgery | MI | Allopathic & Osteopathic Physicians | |
| N | 208100000X | Physical Medicine & Rehabilitation | MI | Allopathic & Osteopathic Physicians | |
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
MI | Allopathic & Osteopathic Physicians | |
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
MI | Ambulatory Health Care Facilities | |
| Y | 207Q00000X | Family Medicine | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS GROUP NUMBER | 700E031600 | 01 |
| Other Name | Type Code |
|---|---|
| Medical Resources Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356775001 | Ascension Macomb Oakland Hospital | Internal Medicine | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2013-08-29 |
| 1548609761 | Ascension Macomb Oakland Hospital | Social Worker | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2013-06-20 |
| 1083872923 | Ascension Macomb Oakland Hospital | Emergency Medicine | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-28 |
| 1518124320 | Ascension Macomb Oakland Hospital | Internal Medicine | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1871793505 | Ascension Macomb Oakland Hospital | Nurse Anesthetist, Certified Registered | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2007-07-20 |
| 1427251420 | Ascension Macomb Oakland Hospital | Psychiatric Unit | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2007-06-07 |
| 1215139233 | Ascension Macomb Oakland Hospital | General Acute Care Hospital | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2007-06-01 |
| 1578696092 | Ascension Macomb Oakland Hospital | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2007-03-13 |
| 1114962461 | Ascension Macomb Oakland Hospital | Neurological Surgery | 27450 Schoenherr Rd, Suite 200, Warren, MI 48088-6683 | 2006-06-19 |
| 1396789434 | Ascension Macomb Oakland Hospital | Nurse Anesthetist, Certified Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2006-06-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ASCENSION MACOMB OAKLAND HOSPITAL | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
| 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 |
| 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 | 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.