Individual provider Active NPI

Braswell Drue Deen, MD

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1003810839
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301064835 Issued in MI
Practice address
22250 Providence Dr
5TH Floor.FL 5
Southfield, MI 48075-4825
Phone
(248) 849-3441
Fax
(248) 849-5389
NPI assigned
Jun 9, 2005
Last updated
Feb 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301064835 MI Primary

Addresses

Primary practice location

22250 Providence Dr
5TH Floor.FL 5
Southfield, MI 48075-4825

Mailing address

15990 W 9 Mile Rd
Southfield, MI 48075-4826
Phone (248) 849-4226

Other identifiers 1

IdentifierTypeStateIssuer
339549910MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000738 MI Practitioner - Family Practice 1557402872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26750 Providence Pkwy
Novi, MI 48374-1211
Phone (248) 465-4782

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301064835MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Sep 15, 1997 Accepting new patients
Henry Ford Health Providence Hospital Family Medicine CurrentSince Sep 15, 1997 Accepting new patients
Henry Ford Health Providence Hospital Current Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

26750 Providence Pkwy
Novi, MI 48374
Phone (248) 465-4782

15990 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 849-5692

16001 W 9 Mile Rd
Fl 5
Southfield, MI 48075
Phone (248) 380-4335

22250 Providence Dr
Fl 5
Southfield, MI 48075
Phone (248) 849-3441

22250 Providence Dr
Ste 500
Southfield, MI 48075
Phone (248) 849-3441

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: bdeen1124813@direct.hfhs.org
  • Direct secure messaging: braswell.deen.1@16555.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1003810839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15990 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754826",
            "telephone_number": "248-849-4226",
            "fax_number": "248-849-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "5TH FLOOR.FL 5",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-849-3441",
            "fax_number": "248-849-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEN",
        "first_name": "BRASWELL",
        "middle_name": "DRUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301064835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339549910",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.