Organization Active NPI

Mi Family Medical Center

  • Family Medicine Physician
  • Novi, MI
National Provider Identifier
1104536069
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MI FAMILY MEDICAL CENTER
Practice address
23985 Novi Rd Ste B102
Novi, MI 48375-5436
Phone
(248) 983-1130
Fax
(833) 983-2929
NPI assigned
Dec 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Lauren Lacute, DONPI 1982049003
Title
Owner
Phone
(440) 228-6290

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

23985 Novi Rd Ste B102
Novi, MI 48375-5436

Mailing address

23985 Novi Rd Ste B102
Novi, MI 48375-5436
Phone (248) 983-1130

Other practice location 1

23985 Novi Rd Ste B102
Novi, MI 48375-5436
Phone (248) 983-1130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230607000943 MI Part B Supplier - Clinic/Group Practice 6103283114 Receives reassigned benefits from 2 practitioners
Practice locations: Novi, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2277045Mi Family Medical Center23985 Novi Road Suite B-102, Novi, MI 48375Certificate of waiverFeb 20, 2027

National Provider Directory

National Provider Directory

Locations

23985 Novi Rd
Ste B102
Novi, MI 48375
Phone (248) 344-7400

Practitioners & affiliated clinicians

Practitioners 2

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": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1104536069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23985 NOVI RD STE B102",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755436",
            "telephone_number": "248-983-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23985 NOVI RD STE B102",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755436",
            "telephone_number": "248-983-1130",
            "fax_number": "833-983-2929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23985 Novi Rd Ste B102",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483755436",
            "country_code": "US",
            "telephone_number": "248-983-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MI FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "LACUTE",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-228-6290",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.