Individual provider Active NPI

Mitchell T Pace, D.O.

  • Diagnostic Radiology Physician
  • Detroit, MI
National Provider Identifier
1104994847
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101010036 Issued in MI
Practice address
Henry Ford Health System
2799 West Grand Boulevard-Diag Rad
Detroit, MI 48202
Phone
(313) 916-7425
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 5101010036 MI
Diagnostic Radiology Physician 2085R0202X 5101010036 MI Primary

Addresses

Primary practice location

Henry Ford Health System
2799 West Grand Boulevard-Diag Rad
Detroit, MI 48202

Mailing address

Henry Ford Health System
2799 West Grand Boulevard-Diag Rad
Detroit, MI 48202
Phone (313) 916-7425

Other identifiers 2

IdentifierTypeStateIssuer
MP010036OtherCHAMPUS-CHAMPUS
MP010036OtherCOMMERCIAL-COMMERCIAL NUMBER

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
I20100604000804 MI Practitioner - Diagnostic Radiology 2163552993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Nova Southeastern Univ College of Dental Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Troy Internal Medicine, PCGroup PAC ID 0840282067, 42 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

4600 Investment Dr
Troy, MI 48098-6368
Phone (248) 267-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101010036MIMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Diagnostic Radiology CurrentSince Jul 1, 2001 Accepting new patients
Henry Ford Macomb Hospital Corporation Diagnostic Radiology CurrentSince Jan 10, 2020 Accepting new patients
Henry Ford Health System CurrentSince Jul 1, 2001 Accepting new patients
Henry Ford Macomb Hospital Corporation Diagnostic Radiology CurrentSince Jan 10, 2020 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Troy Internal Medicine, PC CurrentSince May 1, 2021 Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

4600 Investment Dr
Ste 300
Troy, MI 48098
Phone (248) 267-5000

Interoperability endpoints

  • Direct secure messaging: mpace16740@direct.hfhs.org

Organizations & group practices 7

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 5

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104994847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD-DIAG RAD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD-DIAG RAD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "MITCHELL",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": "5101010036",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101010036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "MP010036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "MP010036",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.