Individual provider Active NPI

Miguel Granados, MD

  • Family Medicine Physician
  • Canton, MI
National Provider Identifier
1043283286
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301061850 Issued in MI
Practice address
5958 N Canton Center Rd
Ste 200
Canton, MI 48187-2769
Phone
(734) 667-1648
Fax
(734) 667-1649
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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 4301061850 MI Primary

Addresses

Primary practice location

5958 N Canton Center Rd
Ste 200
Canton, MI 48187-2769

Mailing address

5958 N Canton Center Rd
Ste 200
Canton, MI 48187-2769
Phone (734) 667-1648

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
I20040614000645 MI Practitioner - Family Practice 5698759264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5958 N Canton Ctr Rd
Suite 200
Canton, MI 48187-2769
Phone (734) 667-1648

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Family Medicine and Medical Spa, PLLC CurrentSince Jul 1, 2013 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

5958 N Canton Center Rd
Ste 200
Canton, MI 48187
Phone (734) 454-5454

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1043283286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5958 N CANTON CENTER RD",
            "address_2": "STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872769",
            "telephone_number": "734-667-1648",
            "fax_number": "734-667-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 N CANTON CENTER RD",
            "address_2": "STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872769",
            "telephone_number": "734-667-1648",
            "fax_number": "734-667-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "MIGUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301061850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.