Bryce Taylor Anderson (NPI# 1548759350, PAC ID# 4284980905) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1548759350 |
| PAC ID by PECOS | 4284980905 |
| Professional Enrollment ID | I20180710002564 |
| Full Name | Bryce Taylor Anderson |
| Organization Legal Name | THE PAIN CENTER USA PLLC |
| Address |
22480 Kelly Rd Suite 1 Eastpointe MI 48021-2623 |
| Phone Number | 5867767400 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3375530215 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230165 | ST JOHN HOSPITAL AND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 22480 Kelly Rd, Suite 1, Eastpointe, MI 48021-2623 | 5867767400 | THE PAIN CENTER USA PLLC |
| 27423 Van Dyke Ave, Warren, MI 48093-2867 | 5867559855 | THE PAIN CENTER USA PLLC |
| Organization Legal Name | THE PAIN CENTER USA PLLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher R Russo | Anesthesiology | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Brent C Russell | Physician Assistant | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Tatyana Bezpalko | Nurse Practitioner | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Rajendra Bothra | Pain Management | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| David L Lewis Jr. | Anesthesiology | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Diane B Campbell | Nurse Practitioner | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Ganiu A Edu | Anesthesiology | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Eric N Backos | Physical Medicine and Rehabilitation | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Chantale E Bothuell | Podiatry | The Pain Center Usa Pllc | 27423 Van Dyke Ave, Warren, MI 48093-2867 |
| Street Address |
22480 KELLY RD SUITE 1 |
| City | EASTPOINTE |
| State | MI |
| Zip | 48021-2623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas K Thomas | Family Medicine | 22480 Kelly Rd, Suite 2, Eastpointe, MI 48021-2623 | |
| Alphonse A Ekole | Family Medicine | 22480 Kelly Rd, Suite 103, Eastpointe, MI 48021-2623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Suthin Liptawat | General Practice | 15200 E 10 Mile Rd, Eastpointe, MI 48021-1010 | |
| Nwanneka U Odumodu | Family Medicine | 16184 E 10 Mile Rd, Suite 101, Eastpointe, MI 48021-1160 | |
| Magdalena A Oleksy | Nurse Practitioner | Michigan Primary Care Pllc | 17000 E 10 Mile Rd, Eastpointe, MI 48021-1263 |
| Colleen Miller | Nurse Practitioner | Michigan Primary Care Pllc | 17000 E 10 Mile Rd, Eastpointe, MI 48021-1263 |
| Gary G Bill | Internal Medicine | Michigan Primary Care Pllc | 17000 E 10 Mile Rd, Eastpointe, MI 48021-1263 |
| Aleksandra Tasevski | Nurse Practitioner | Michigan Primary Care Pllc | 17000 E 10 Mile Rd, Eastpointe, MI 48021-1263 |
| Zbigniew Purzycki | Internal Medicine | Michigan Primary Care Pllc | 17000 E 10 Mile Rd, Eastpointe, MI 48021-1263 |
| Peter C Dodenhoff | Family Practice | Michigan Primary Care Pllc | 17000 E 10 Mile Rd, Eastpointe, MI 48021-1263 |
| Andrea D Zinke | Nurse Practitioner | Michigan Healthcare Professionals PC | 24901 Kelly Rd, Eastpointe, MI 48021-1367 |
| Haley M Pope | Family Medicine | Michigan Healthcare Professionals PC | 24901 Kelly Rd, Eastpointe, MI 48021-1367 |
| Find all physicians in zip 48021 | |||
| City | EASTPOINTE |
| Zip Code | 48021 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | EASTPOINTE + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.