NPIMap

Organization Active NPI

ENT Specialists, P.C.

  • Otolaryngology Physician
  • Novi, MI
National Provider Identifier
1104996842
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT SPECIALISTS, P.C.
Practice address
25500 Meadowbrook Rd
Ste 220
Novi, MI 48375-1878
Phone
(248) 477-7020
Fax
(248) 477-2440
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Jessica Mackie
Title
Practice Manager
Phone
(248) 477-7020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

25500 Meadowbrook Rd
Ste 220
Novi, MI 48375-1878

Mailing address

25500 Meadowbrook Rd Ste 220
Novi, MI 48375-1882
Phone (248) 477-7020

Other practice location 1

6249 Grand River Rd
Brighton, MI 48114-5305
Phone (248) 477-7020

Other practice location 2

31100 Telegraph Rd Ste 230
Bingham Farms, MI 48025-4347
Phone (248) 477-7020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070717000258 MI Part B Supplier - Clinic/Group Practice 0648370874 Receives reassigned benefits from 16 practitioners
Practice locations: Bingham Farms, MI; Brighton, MI; Novi, MI

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

31100 Telegraph Rd
Ste 230
Bingham Farms, MI 48025
Phone (248) 453-9300

7575 Grand River Rd
Ste 110
Brighton, MI 48114
Phone (810) 844-7050

6249 Grand River Rd
Brighton, MI 48114
Phone (810) 844-1900

25500 Meadowbrook Rd
Ste 170
Novi, MI 48375

25500 Meadowbrook Rd
Ste 220
Novi, MI 48375
Phone (248) 477-7020

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1104996842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 220",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751882",
            "telephone_number": "248-477-7020",
            "fax_number": "248-477-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD",
            "address_2": "STE 220",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751878",
            "telephone_number": "248-477-7020",
            "fax_number": "248-477-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6249 Grand River Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481145305",
            "country_code": "US",
            "telephone_number": "248-477-7020",
            "fax_number": "248-477-2440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31100 Telegraph Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Bingham Farms",
            "state": "MI",
            "postal_code": "480254347",
            "country_code": "US",
            "telephone_number": "248-477-7020",
            "fax_number": "248-477-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENT SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "MACKIE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "248-477-7020"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "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 Jan 28, 2026; 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.