Organization Active NPI

Robin M Moherek MD PC

  • Obstetrics & Gynecology Physician
  • Clawson, MI
National Provider Identifier
1033257761
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301067326 Issued in MI
Legal business name
ROBIN M MOHEREK MD PC
Practice address
555 W 14 Mile Road
Suite 205
Clawson, MI 48017-3100
Phone
(248) 288-3622
Fax
(248) 288-3625
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Authorized official

Name
Dr. Robin Marie Moherek, MDNPI 1386724524
Title
Owner
Phone
(248) 288-3622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 4301067326 MI Primary

Addresses

Primary practice location

555 W 14 Mile Road
Suite 205
Clawson, MI 48017-3100

Mailing address

555 W 14 Mile Road
Suite 205
Clawson, MI 48017-3100
Phone (248) 288-3622

Other identifiers 2

IdentifierTypeStateIssuer
700F343640OtherMIBCN
700F343640OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070508000574 MI Part B Supplier - Clinic/Group Practice 3779689765 Receives reassigned benefits from 1 practitioner
Practice locations: Clawson, MI

National Provider Directory

National Provider Directory

Locations

555 W 14 Mile Rd
Ste 205
Clawson, MI 48017
Phone (248) 288-3622

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1033257761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W 14 MILE ROAD",
            "address_2": "SUITE 205",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480173100",
            "telephone_number": "248-288-3622",
            "fax_number": "248-288-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W 14 MILE ROAD",
            "address_2": "SUITE 205",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480173100",
            "telephone_number": "248-288-3622",
            "fax_number": "248-288-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBIN M MOHEREK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "MOHEREK",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-288-3622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301067326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "700F343640",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700F343640",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clawson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.