Individual provider Active NPI

Renato Roxas Jr, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1124065727
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301074766 Issued in MI
Practice address
4201 Saint Antoine St Ste 6a
Detroit, MI 48201-2153
Phone
(313) 745-4525
Fax
(313) 966-7305
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301074766 MI
Internal Medicine Physician 207R00000X 4301074766 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St Ste 6a
Detroit, MI 48201-2153

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

Other practice location 1

400 Mack Ave
Detroit, MI 48201-2136
Phone (313) 448-9650

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
I20040825000796 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3779557624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Cincinnati College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

1560 E Maple Rd
Troy, MI 48083-1135
Phone (248) 581-5200

261 Mack Ave
Detroit, MI 48201-2417
Phone (313) 745-4600

3980 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040

3990 John R St
Detroit, MI 48201-2018

400 Mack Ave
Detroit, MI 48201-2136
Phone (313) 448-9006

400 Mack Ave 2
Detroit Mack Health Center
Detroit, MI 48201-2136
Phone (313) 448-9006

400 Mack Ave 2 West-Credentialing Dept
Detroit, MI 48201-2136

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

4201 Saint Antoine St
Detroit, MI 48201-2153

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301074766MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Feb 8, 2005 Accepting new patients
University Pediatricians Pediatrics CurrentSince Feb 8, 2005 Accepting new patients
University Physician Group Internal Medicine CurrentSince Oct 1, 2006 Accepting new patients
University Physician Group CurrentSince Oct 1, 2006 Accepting new patients
University Physician Group Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients
University Physician Group Past Accepting new patients
Barbara Ann Karmanos Cancer Hospital Past Accepting new patients

Locations

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3950 Beaubien St
Fl 4
Detroit, MI 48201
Phone (313) 832-9220

4201 Saint Antoine St
Ste 6A
Detroit, MI 48201
Phone (313) 745-4230

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

50 E Canfield St
Detroit, MI 48201
Phone (313) 577-9704

3901 Beaubien St
Fl 4
Detroit, MI 48201
Phone (313) 745-4878

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: renato.roxas.jr.1@19711.direct.athenahealth.com
  • Direct secure messaging: rroxas@direct.dmc.org

Organizations & group practices 9

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1124065727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 6A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4525",
            "fax_number": "313-966-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012136",
            "country_code": "US",
            "telephone_number": "313-448-9650",
            "fax_number": "313-448-9979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROXAS JR",
        "first_name": "RENATO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301074766",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301074766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.