NPIMap

Individual provider Active NPI

Elliott I Greenspan, D.O.

  • Internal Medicine Physician
  • Bloomfield Hills, MI
National Provider Identifier
1003803966
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101005633 Issued in MI
Practice address
6962 Spruce Hill CT
Bloomfield Hills, MI 48301-3704
Phone
(248) 245-4833
NPI assigned
Oct 5, 2005
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101005633 MI Primary

Addresses

Primary practice location

6962 Spruce Hill CT
Bloomfield Hills, MI 48301-3704

Mailing address

6962 Spruce Hill CT
Bloomfield Hills, MI 48301-3704
Phone (248) 245-4833

Other identifiers 4

IdentifierTypeStateIssuer
1188028-11MedicaidMI
4865778-11MedicaidMI
1791545-11MedicaidMI
3142396-11MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091124000348 MI Practitioner - Internal Medicine 3577459064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29600 S Wixom Rd
Wixom, MI 48393-3459
Phone (248) 668-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101005633MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott I. Greenspan, D.O., P.C. & Associates Internal Medicine CurrentSince Jan 1, 1974 Accepting new patients
Park Family Health Care, P.C. CurrentSince Apr 15, 2019 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

2255 Fort St
Lincoln Park, MI 48146
Phone (313) 357-7500

28212 Franklin Rd
Southfield, MI 48034

29600 S Wixom Rd
Wixom, MI 48393
Phone (248) 668-1900

L4198
Columbus, OH 43260

Interoperability endpoints

  • Direct secure messaging: egreensp@direct.dmc.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1003803966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6962 SPRUCE HILL CT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013704",
            "telephone_number": "248-245-4833",
            "fax_number": "248-737-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6962 SPRUCE HILL CT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013704",
            "telephone_number": "248-245-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENSPAN",
        "first_name": "ELLIOTT",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101005633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1188028-11",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4865778-11",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1791545-11",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3142396-11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.