MICHIGAN INSTITUTE OF UROLOGY PC (NPI# 1801018338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801018338 |
| Entity Type | Organization |
| Organization Name | MICHIGAN INSTITUTE OF UROLOGY PC |
| Practice Address |
20952 E 12 Mile Rd Suite 200 Saint Clair Shores MI 48081-3200 |
| Practice Telephone | 5867714820 |
| Practice Fax Number | 5867717960 |
| Mailing Telephone | 5867714820 |
| Mailing Fax Number | 5867717960 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-05-15 |
| Authorized Official Name | ALPHONSE SANTINO (PRESIDENT) |
| Authorized Official Telephone | 5867714820 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MICHIGAN INSTITUTE OF UROLOGY PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | CB9133 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194807693 | Michigan Institute of Urology PC | Urology | 6900 Orchard Lake Road, Suite 101, West Bloomfield, MI 48322-3424 | 2006-10-20 |
| 1427027416 | Michigan Institute of Urology PC | Pathology | 20952 12 Mile Rd, Suite 200, St Clair Shores, MI 48081-3203 | 2006-03-14 |
| 1962674499 | Michigan Institute of Urology PC | Urology | 130 Town Center Dr, Suite 200, Troy, MI 48084-1744 | 2008-03-25 |
| 1730393927 | Michigan Institute of Urology PC | Durable Medical Equipment & Medical Supplies | 20952 12 Mile Road, 200, Saint Clair Shores, MI 48081-3203 | 2007-05-09 |
| 1801978309 | Michigan Institute of Urology PC | Urology | 2300 Haggerty Road, Suite 2000, West Bloomfield, MI 48323-2102 | 2006-10-20 |
| 1295817799 | Michigan Institute of Urology PC | Urology | 130 Town Center Drive, Suite 101, Troy, MI 48084-1773 | 2006-10-20 |
| 1881776383 | Michigan Institute of Urology PC | Urology | 44200 Woodward, Suite 207, Pontiac, MI 48341 | 2006-10-20 |
| 1871673962 | Michigan Institute of Urology PC | Urology | 18100 Oakwood Blvd, Suite 315, Dearborn, MI 48124-4085 | 2006-10-16 |
| 1326138033 | Michigan Institute of Urology PC | Urology | 11051 Hall Rd, Suite 200, Utica, MI 48317-5735 | 2006-10-13 |
| 1275623068 | Michigan Institute of Urology PC | Urology | 5701 Bow Pointe Dr, Suite 250, Clarkston, MI 48346-3163 | 2006-10-13 |
| Street Address |
20952 E 12 MILE RD SUITE 200 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295724060 | Scott I Sircus | Urology | 20952 E 12 Mile Rd, Suite 200, Saint Clair Shores, MI 48081-3200 | 2005-10-14 |
| 1962976449 | Nathan A Gura | Physical Therapist | 20952 E 12 Mile Rd, Saint Clair Shores, MI 48081-3200 | 2019-01-17 |
| 1083104756 | Natalie Sutherland | Physical Therapist | 20952 E 12 Mile Rd, Saint Clair Shores, MI 48081-3200 | 2018-05-17 |
| 1457852287 | Kristin A Smith | Physical Therapist | 20952 E 12 Mile Rd, Saint Clair Shores, MI 48081-3200 | 2018-02-27 |
| 1235638370 | Katie Herman | Physical Therapist | 20952 E 12 Mile Rd, Saint Clair Shores, MI 48081-3200 | 2018-02-05 |
| 1376094177 | Danielle Marie Downs | Nurse Practitioner | 20952 E 12 Mile Rd, Suite 100, Saint Clair Shores, MI 48081-3200 | 2016-10-18 |
| 1487912812 | Jennifer M Buszka | Nurse Practitioner | 20952 E 12 Mile Rd, Suite 200, Saint Clair Shores, MI 48081-3200 | 2012-04-23 |
| 1457592990 | Zachary Jonathan Liss | Urology | 20952 E 12 Mile Rd, Suite 200, Saint Clair Shores, MI 48081-3200 | 2009-03-12 |
| 1629223821 | Jennifer Jo Starrs | Nurse Practitioner | 20952 E 12 Mile Rd, Suite 200, Saint Clair Shores, MI 48081-3200 | 2008-12-01 |
| 1184812992 | Scott Wilkinson | Urology | 20952 E 12 Mile Rd, Suite 200, Saint Clair Shores, MI 48081-3200 | 2007-10-05 |
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801316989 | Olivia Charlotte-anne Murthy | Nurse Practitioner | 23715 Little Mack Ave Ste A, Saint Clair Shores, MI 48080-1181 | 2017-06-21 |
| 1427690734 | Stefan M Smolenski | Nurse Practitioner | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2019-10-09 |
| 1639656721 | Kali M Mcleod | Nurse Practitioner | 28001 Harper Ave, Saint Clair Shores, MI 48081-1561 | 2018-07-23 |
| 1881107738 | Meghan Elizabeth Gallagher | Nurse Practitioner | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2017-11-14 |
| 1578940656 | Kimberly Cannon | Nurse Practitioner | 28315 Harper Ave, Saint Clair Shores, MI 48081-1687 | 2015-04-28 |
| 1649525288 | Elizabeth Perrotta | Nurse Practitioner | 23715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1181 | 2012-07-19 |
| 1720107089 | Cheryl Lang | Nurse Practitioner | 19699 E 8 Mile Rd, Saint Clair Shores, MI 48080-1655 | 2007-03-28 |
| 1992742753 | Jean A Edmondson | Nurse Practitioner | 23829 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-1186 | 2006-06-01 |
| 1295781540 | Linda Mcparlan | Nurse Practitioner | 23829 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-1186 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| 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.