ASCENSION MEDICAL GROUP MICHIGAN (NPI# 1366515496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366515496 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP MICHIGAN |
| Practice Address |
21000 E 12 Mile Rd Suite 102 Saint Clair Shores MI 48081-1116 |
| Mailing Address |
2800 Livernois Rd Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 5864475100 |
| Practice Fax Number | 5864475090 |
| Mailing Telephone | 2486808000 |
| Mailing Fax Number | 2486808031 |
| Enumeration Date | 2006-11-16 |
| 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 | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE GROUP NUMBER | 0M92780 | 01 |
| MI | RAILROAD MEDICARE GROUP NUMBER | CG4683 | 01 |
| MI | BCBSM GROUP NUMBER | 0E01168 | 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 |
21000 E 12 MILE RD SUITE 102 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-1116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255330486 | Jennifer Kay Appleyard | Allergy & Immunology | 21000 E 12 Mile Rd, Ste 111, Saint Clair Shores, MI 48081-1116 | 2005-07-19 |
| 1881203479 | Andrew Michael Keltz | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2020-07-29 |
| 1770120230 | Holly Ann Reckers | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2019-12-04 |
| 1578037966 | Maria Juliana Codino | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2019-01-18 |
| 1942779921 | Maria D Samsa | Physician Assistant | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2018-11-19 |
| 1801331210 | Katja N Tandarich | Nurse Practitioner | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2016-12-21 |
| 1053854133 | Jean P. Skeffington | Speech-Language Pathologist | 21000 E 12 Mile Rd, Suite111, Saint Clair Shores, MI 48081-1116 | 2016-11-22 |
| 1134588254 | Alyssa Domenica Baker | Physician Assistant | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2016-02-17 |
| 1316350192 | Seton Health Corporation of Southeastern Michigan | Clinic/Center | 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 | 2014-06-09 |
| 1720404775 | Sean Anthony Cassleman | Internal Medicine | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2014-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215148689 | Regina Frost | Obstetrics & Gynecology | 22050 Mack Ave, Saint Clair Shores, MI 48080-2388 | 2007-05-25 |
| 1346360229 | Joyce Catherine Purakal | Obstetrics & Gynecology | 21000 E 12 Mile Rd Ste 102, Saint Clair Shores, MI 48081-1156 | 2007-04-02 |
| 1396185708 | Rachel Mclaurin Matthews | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2013-06-29 |
| 1508099193 | Compassionate Womens Healthcare | Obstetrics & Gynecology | 22050 Greater Mack Ave, Saint Clair Shores, MI 48080-2388 | 2009-08-28 |
| 1205091071 | Abessinio Obstetrics & Gynecology, P.C. | Obstetrics & Gynecology | 22811 Greater Mack Ave, Suite 106, Saint Clair Shores, MI 48080-2021 | 2008-07-22 |
| 1821256116 | Susan A. Radtke, M.d., P.C. | Obstetrics & Gynecology | 21321 Harper Ave, Suite A, Saint Clair Shores, MI 48080-2243 | 2008-05-23 |
| 1427125897 | Wontika R. Smith | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-11-29 |
| 1679657613 | Women To Women Health Center PC | Obstetrics & Gynecology | 23715 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-1181 | 2006-10-25 |
| 1164535886 | St Clair Shores Obstetrics and Gynecolgy, Plc | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-08-16 |
| 1033129630 | Suzanne M Millican | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-08-08 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
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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.