Organization Active NPI

Brian T Doyle MD PLC

  • Family Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1114403615
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301110561 Issued in MI
Legal business name
BRIAN T DOYLE MD PLC
Practice address
405 Momany Dr
Saint Joseph, MI 49085-2178
Phone
(269) 982-1947
Fax
(269) 982-1950
NPI assigned
Jul 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Brian T Doyle, MDNPI 1750677316
Title
Sole Member
Phone
(248) 345-9864

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 4301110561 MI Primary

Addresses

Primary practice location

405 Momany Dr
Saint Joseph, MI 49085-2178

Mailing address

405 Momany Dr
Saint Joseph, MI 49085-2178
Phone (269) 982-1947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180921000637 MI Part B Supplier - Clinic/Group Practice 6709137250 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Joseph, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1114403615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MOMANY DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852178",
            "telephone_number": "269-982-1947",
            "fax_number": "269-982-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MOMANY DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852178",
            "telephone_number": "269-982-1947",
            "fax_number": "269-982-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN T DOYLE MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "248-345-9864",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301110561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.