NPIMap

Organization Active NPI

Tenny Internal Medicine PLLC

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1093346611
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TENNY INTERNAL MEDICINE PLLC
Practice address
22361 W Village Dr
Dearborn, MI 48124-2227
Phone
(313) 563-2288
Fax
(313) 561-7065
NPI assigned
Feb 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Matthew Marcarian, MDNPI 1891773677
Title
Owner
Phone
(313) 563-2288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

22361 W Village Dr
Dearborn, MI 48124-2227

Mailing address

22361 W Village Dr
Dearborn, MI 48124-2227
Phone (313) 563-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200623001724 MI Part B Supplier - Clinic/Group Practice 5991127896 Receives reassigned benefits from 6 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Locations

22361 W Village Dr
Dearborn, MI 48124
Phone (313) 350-5859

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20892/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1093346611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22361 W VILLAGE DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242227",
            "telephone_number": "313-563-2288",
            "fax_number": "313-561-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22361 W VILLAGE DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242227",
            "telephone_number": "313-563-2288",
            "fax_number": "313-561-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNY INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-02",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "MARCARIAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-563-2288",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.