Individual provider Active NPI

Robert Breakey, M.D.

  • Family Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1063481281
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301046917 Issued in MI
Practice address
4940 W Clark Rd
Ste 100
Ypsilanti, MI 48197-0860
Phone
(734) 971-1188
Fax
(734) 971-3658
NPI assigned
Mar 17, 2006
Last updated
Sep 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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 4301046917 MI Primary

Addresses

Primary practice location

4940 W Clark Rd
Ste 100
Ypsilanti, MI 48197-0860

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

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
I20100611000396 MI Practitioner - Family Practice 4789714122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1065 N Huron River Dr
Ypsilanti, MI 48197-3296

4936 W Clark Rd
Ypsilanti, MI 48197-0861
Phone (734) 434-6200

4940 W Clark Rd
Ypsilanti, MI 48197-0860
Phone (734) 971-1188

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301046917MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation CurrentSince Sep 4, 2013 Accepting new patients
Iha Health Service Corporation CurrentSince Sep 4, 2013 Accepting new patients

Locations

2004 Hogback Rd
Ste 14
Ann Arbor, MI 48105
Phone (734) 786-2300

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

4940 W Clark Rd
Ste 100
Ypsilanti, MI 48197
Phone (734) 434-0477

Interoperability endpoints

  • Direct secure messaging: rbreakey26025@direct.trinity-health.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 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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1063481281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 W CLARK RD",
            "address_2": "STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970860",
            "telephone_number": "734-971-1188",
            "fax_number": "734-971-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAKEY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301046917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.