NPIMap

Individual provider Active NPI

Robert Lewis Elgin, D.O.

  • Urology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1053674101
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
5101020106 Issued in MI
Practice address
20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203
Phone
(586) 771-4820
Fax
(586) 771-6620
NPI assigned
Jun 22, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 5101020106 MI Primary

Addresses

Primary practice location

20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203

Mailing address

20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

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
I20170605002244 MI Practitioner - Urology 9436443173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Philadelphia College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

36500 S Gratiot Ave
102 Multispecialties
Clinton Township, MI 48035-1772
Phone (586) 790-9003

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020106MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Macomb Urology CurrentSince Jul 5, 2017 Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Jul 1, 2017 Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Jul 1, 2017 Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients

Locations

36500 S Gratiot Ave
Ste 102
Clinton Twp, MI 48035
Phone (586) 790-9003

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

19991 Hall Rd
Ste 201
Macomb, MI 48044
Phone (586) 228-0150

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

44344 Dequindre Rd
Ste 210
Sterling Heights, MI 48314
Phone (586) 323-4200

11051 Hall Rd
Ste 200
Utica, MI 48317
Phone (586) 254-5759

Interoperability endpoints

  • Direct secure messaging: relgin255360@direct.hfhs.org

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 7

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053674101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELGIN",
        "first_name": "ROBERT",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101020106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.