NPIMap

Organization Active NPI

ENT Care of Michigan PLC

  • Otolaryngology Physician
  • Waterford, MI
National Provider Identifier
1114632932
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT CARE OF MICHIGAN PLC
Practice address
5220 Highland Rd Ste 230
Waterford, MI 48327-1973
Phone
(248) 254-8900
Fax
(248) 599-7191
NPI assigned
Jan 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Eric Succar, MDNPI 1124361621
Title
Owner
Phone
(248) 254-8900

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X

Addresses

Primary practice location

5220 Highland Rd Ste 230
Waterford, MI 48327-1973

Mailing address

5220 Highland Rd Ste 230
Waterford, MI 48327-1973
Phone (248) 254-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230419002237 MI Part B Supplier - Clinic/Group Practice 2466827753 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Sterling Heights, MI; Waterford, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
ENT Care of Michigan2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13860 Canal Rd
Sterling Heights, MI 48313
Phone (248) 254-8900

Practitioners & affiliated clinicians

Practitioners 7

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": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1114632932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD STE 230",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271973",
            "telephone_number": "248-254-8900",
            "fax_number": "248-599-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD STE 230",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271973",
            "telephone_number": "248-254-8900",
            "fax_number": "248-599-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT CARE OF MICHIGAN PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "SUCCAR",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-254-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.