Individual provider Active NPI

Mark S Friedland MD PC, MD

  • Vascular Surgery Physician
  • Troy, MI
National Provider Identifier
1093799637
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301064335 Issued in MI
Practice address
44199 Dequindre Rd
Ste 623
Troy, MI 48085
Phone
(248) 828-5707
Fax
(248) 828-5702
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301064335 MI Primary

Addresses

Primary practice location

44199 Dequindre Rd
Ste 623
Troy, MI 48085

Mailing address

44199 Dequindre Rd
Ste 623
Troy, MI 48085
Phone (248) 828-5707

Other identifiers 1

IdentifierTypeStateIssuer
0633267OtherBLUE CROSS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000769 MI Practitioner - Vascular Surgery 6305976234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Tufts University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

15959 Hall Rd
Macomb, MI 48044-5363
Phone (248) 964-5190

44199 Dequindre Rd
Troy, MI 48085-1128
Phone (248) 828-5707

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-5190

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)21
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark S Friedland MD PC Vascular Surgery CurrentSince Jan 1, 2000 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Jul 31, 2022 Accepting new patients

Locations

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

44199 Dequindre Rd
Ste 623
Troy, MI 48085
Phone (248) 828-5707

Interoperability endpoints

  • Direct secure messaging: mfriedland1456976@epic00.shdirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1093799637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD",
            "address_2": "STE 623",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48085",
            "telephone_number": "248-828-5707",
            "fax_number": "248-828-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD",
            "address_2": "STE 623",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48085",
            "telephone_number": "248-828-5707",
            "fax_number": "248-828-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDLAND MD PC",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301064335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0633267",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.