Individual provider Active NPI

Robert Solomon Issac, NP-C

  • Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1093259228
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704272827 Issued in MI
Practice address
44200 Woodward Ave Ste 112
Pontiac, MI 48341-5046
Phone
(248) 384-8100
Fax
(248) 384-8101
NPI assigned
Dec 7, 2016
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704272827 MI Primary

Addresses

Primary practice location

44200 Woodward Ave Ste 112
Pontiac, MI 48341-5046

Mailing address

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346-3199
Phone (248) 625-2621

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161215000313 MI Practitioner - Nurse Practitioner 3971883620 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

44200 Woodward Ave
Suite 112
Pontiac, MI 48341-5046
Phone (248) 843-0587

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Feb 3, 2025 Accepting new patients
McLaren Community Based Primary Care Group Family CurrentSince Jan 1, 2026 Accepting new patients
McLaren Community Based Primary Care Group CurrentSince Jan 1, 2026 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Feb 3, 2025 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Feb 3, 2025 Accepting new patients

Locations

5701 Bow Pointe Dr
Ste 100
Clarkston, MI 48346
Phone (248) 625-2621

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

44200 Woodward Ave
Ste 112
Pontiac, MI 48341
Phone (248) 384-8100

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3601 W 13 Mile Rd
Royal Oak, MI 48073

Interoperability endpoints

  • Direct secure messaging: rissac940718@direct.hfhs.org
  • Direct secure messaging: robert.issac.1@3928.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1093259228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE STE 112",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415046",
            "telephone_number": "248-384-8100",
            "fax_number": "248-384-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSAC",
        "first_name": "ROBERT",
        "middle_name": "SOLOMON",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-07",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704272827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.