MMG 1PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MMG 1PC

Doing business as

Comprehensive Internists

Practice address

6900 Orchard Lake Rd
Suite 303
West Bloomfield, MI 48322-3405

Phone

(248) 851-4192

Fax

(248) 737-9774

NPI assigned

Jul 12, 2006

Last updated

Sep 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Geoffrey A Trivax, MD

Title

President

Phone

(313) 538-3099

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COMPREHENSIVE INTERNISTS Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• MMG 1 PC

  • Nurse Practitioner
  • Southfield, MI
  • NPI 1023037025

  O20031104000106

  Same enrollment
• MMG 1 PC

  dba Internal Medicine Specialists

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1023043486

  O20031104000106

  Same enrollment
• MMG 1 PC

  dba Millenium Diagnostic Center

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1912933540

  O20031104000106

  Same enrollment
• MMG 1 PC

  dba Internal Medicine Physicians

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1982639357

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Internal Medicine Plus

  • Internal Medicine Physician
  • Bingham Farms, MI
  • NPI 1154356517

  O20031104000106

  Same enrollment
• MMG 1PC

  • Family Medicine Physician
  • West Bloomfield, MI
  • NPI 1205855186

  O20031104000106

  Same enrollment
• MMG 1PC

  • Internal Medicine Physician
  • Bingham Farms, MI
  • NPI 1225063688

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Associated Rheumatology Consultants

  • Rheumatology Physician
  • Southfield, MI
  • NPI 1629184049

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Premier Internists

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1679586192

  O20031104000106

  Same enrollment

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1073548442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD",
            "address_2": "SUITE 303",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223405",
            "telephone_number": "248-851-4192",
            "fax_number": "248-737-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG 1PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "TRIVAX",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-538-3099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "700F319060",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "CJ5820",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMPREHENSIVE INTERNISTS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMPREHENSIVE INTERNISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin Mitchell
• Lashanta Ericka Mitchell
• Lawrence C. Mitchell, M.D.
• Marla Mitchell, LLMSW
• MMG 1 PC (Internal Medicine Specialists)
• MMG 1PC
• MMS Northern Detroit, Inc (Majors Medical Supply)
• Hadley Merritt Moak
• Mobile Physicians Association PC
• Moca Group PC (Women's Health Care Physicians)

• Internal Medicine Physician in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.