Active NPI
Michigan Minimally Invasive Neurosurgical Institute PLLC
- Neurological Surgery Physician
- Waterford, MI
National Provider Identifier
1114704764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- Legal business name
- MICHIGAN MINIMALLY INVASIVE NEUROSURGICAL INSTITUTE PLLC
- Practice address
- 5220 Highland Rd Ste 210
Waterford, MI 48327-1973 - Phone
- (248) 383-1030
- Fax
- (248) 383-1031
- NPI assigned
- Sep 8, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Miguelangelo J Perez-Cruet, MD
- Title
- Owner
- Phone
- (248) 535-6952
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | Primary |
Addresses
Primary practice location
5220 Highland Rd Ste 210
Waterford, MI 48327-1973
Mailing address
1070 Timberlake Dr
Bloomfield Hills, MI 48302-2849
Phone (248) 383-1030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Waterford, MI
- NPI 1649152489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694131200000",
"number": "1114704764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 TIMBERLAKE DR",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483022849",
"telephone_number": "248-383-1030",
"fax_number": "248-383-1031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5220 HIGHLAND RD STE 210",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483271973",
"telephone_number": "248-383-1030",
"fax_number": "248-383-1031"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHIGAN MINIMALLY INVASIVE NEUROSURGICAL INSTITUTE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-08",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A",
"authorized_official_last_name": "PEREZ-CRUET",
"authorized_official_first_name": "MIGUELANGELO",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "248-535-6952",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Neurological Surgery",
"state": null,
"license": null,
"primary": true
}
],
"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 Sep 8, 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.