Complexcare Medical Group Southeast H PLLC
Organization Active NPI Internal Medicine Physician · Novi, MI
NPI 1083508238 · NPPES record last updated Mar 31, 2026
Key facts
- NPI
- 1083508238
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- COMPLEXCARE MEDICAL GROUP SOUTHEAST H PLLC
- Practice address
- 41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818 - Phone
- (248) 660-1220
- NPI assigned
- Jun 4, 2025
- Organization subpart
- No
Authorized official
- Name
- Svetlana Vinokur
- Title
- Cfo
- Phone
- (847) 275-9504
Practitioners 43
-
Elie Joseph Hercule, M.D.
-
Brittany Danielle Hughes, FNP-C
-
Timothy W Hutchison, M.D.
-
Ugo Alexis Ireh, MD
-
Cassandra Jones, AGNP-C
-
Jennifer Barnes Millbrooks, NURSE PRACTITIONER
-
Griseida Montanez, APRN
-
Ellis Mossaded, M.D.
-
Yolandia Thornton, APRN
-
Grethel Trujillo, FNP
-
Annissa Annette Wilson, FNP-C
-
Gretta Goines Alexander, FNP-BC
-
Carolyn Amburn, FNP-C
-
Karen Elaine Burke, APRN
-
Sahin Coban, MD
-
Jameka Dorsey, NP
-
Chiraly Dutrevil, FNP
-
Martha E Glose, NP
-
Marci K Golden, NP
-
Christie Harrington, APRN, FNP-C
-
Kerrie Ann Lind, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in LA, GA, FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250919004271 | LA | Part B Supplier - Clinic/Group Practice | 9830693993 |
Receives reassigned benefits from 4 practitioners Practice locations: Sulphur, LA; Shreveport, LA; Lake Charles, LA |
| O20250927000363 | GA | Part B Supplier - Clinic/Group Practice | 9830693993 |
Receives reassigned benefits from 29 practitioners Practice locations: Twin City, GA; Tucker, GA; Tifton, GA; Savannah, GA; Roberta, GA; Quitman, GA; Macon, GA; Lagrange, GA… |
| O20251013001399 | FL | Part B Supplier - Clinic/Group Practice | 9830693993 |
Receives reassigned benefits from 5 practitioners Practice locations: Fort Walton Beach, FL; Naples, FL; Niceville, FL; Sarasota, FL; Tarpon Springs, FL |
National Provider Directory
Locations
2145 N Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8787
110 Lee Ave SE
Live Oak, FL 32064
Phone (386) 364-5961
1053 John Sims Pkwy E
Niceville, FL 32578
Phone (850) 768-0213
101 Hartford Rd E
Fort Gaines, GA 39851
211 Mathis Ave
Twin City, GA 30471
Phone (478) 763-2141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818
Mailing address
41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818
Phone (248) 660-1220
Other providers in Novi, MI
- Complexcare Medical Group Mid-Atlantic H PLLC
- Complexcare Medical Group Midwest H PLLC
- Complexcare Medical Group Midwest M PLLC
- Complexcare Medical Group Mountain West H PLLC
- Complexcare Medical Group Northeast H PLLC
- Complexcare Medical Group Southwest H PLLC
- Compone Administrators, Inc
- Comprehensive Medical Practice PC
- Comprehensive Vascular Care
- Comprehensive Vascular Care, P.C.
All providers in Novi, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.