NPIMap

Individual provider Active NPI

Robert N Israel, M.D.

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1083688261
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RI4301052400 Issued in MI
Practice address
124 Seymour Ave
Jackson, MI 49202-3558
Phone
(517) 782-5700
Fax
(517) 782-3141
NPI assigned
Feb 15, 2006
Last updated
Dec 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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 RI4301052400 MI Primary

Addresses

Primary practice location

124 Seymour Ave
Jackson, MI 49202-3558

Mailing address

124 Seymour Ave
Jackson, MI 49202-3558
Phone (517) 782-5700

Other identifiers 1

IdentifierTypeStateIssuer
2602310MedicaidMI

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
I20050617000313 MI Practitioner - Family Practice 5991749111 Reassigns benefits to 4 organizations
Practice locations: Jackson, MI

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

243 Wiley Rd
Douglas, MI 49406-5169
Phone (269) 857-2141

9480 E M
Suite 21
Ovid, MI 48866-9569
Phone (989) 834-2228

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RI4301052400MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Ooma Primary LLC Family Medicine CurrentSince Jul 28, 2021 Accepting new patients
Iha Ooma Primary LLC Family Medicine Current Accepting new patients
Wa Foote Memorial Hospital, Inc Current Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince Jun 10, 2025 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Nov 1, 2006 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Nov 1, 2006 Accepting new patients
Theoria Medical CurrentSince Nov 4, 2024 Accepting new patients
Iha Health Services Corporation CurrentSince Jul 28, 2021 Accepting new patients
Iha Ooma Primary LLC Family Medicine CurrentSince Jul 28, 2021 Accepting new patients
Iha Health Service Corporation CurrentSince Jul 28, 2021 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Atrium Marshall LLC Past Accepting new patients
McBain Nursing Center, LLC Past Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients
Grand Haven Opco LLC Past Accepting new patients
Atrium King Centre LLC Past Accepting new patients
Robert N Israel, MD Family Medicine PastSince Jan 1, 1990 Accepting new patients
Douglas Mi Opco LLC Past Accepting new patients

Locations

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

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

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

2200 Springport Rd
Jackson, MI 49202
Phone (517) 784-9356

2282 Springport Rd
Ste B
Jackson, MI 49202
Phone (517) 782-5700

1375 S Lapeer Rd
Ste 210
Lake Orion, MI 48360
Phone (248) 693-5700

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

37595 7 Mile Rd
Ste 210
Livonia, MI 48152
Phone (734) 432-7282

37595 7 Mile Rd
Ste 340
Livonia, MI 48152
Phone (734) 542-9999

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

9480 E M 21
Ovid, MI 48866
Phone (989) 834-0000

9480 E M 21
Ste 200
Ovid, MI 48866
Phone (989) 834-2228

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

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

1854 W Auburn Rd
Ste 100A
Rochester Hills, MI 48309
Phone (248) 696-3170

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

4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500

Interoperability endpoints

  • Direct secure messaging: risrael444283@direct.hfhs.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marshall Nursing and Rehabilitation CommunityMarshall, MI, CCN 235174 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2025
May 1, 2025
The Orchards at Douglas CoveDouglas, MI, CCN 235447 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2025
Nov 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1083688261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SEYMOUR AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023558",
            "telephone_number": "517-782-5700",
            "fax_number": "517-782-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SEYMOUR AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023558",
            "telephone_number": "517-782-5700",
            "fax_number": "517-782-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "ROBERT",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "RI4301052400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2602310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.