NPIMap

Individual provider Active NPI

Mitchell Becker

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1154070647
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.153946 Issued in OH
Practice address
24911 Little Mack Ave
Saint Clair Shores, MI 48080-3200
Phone
(586) 777-2050
Fax
(586) 777-2189
NPI assigned
Mar 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.153946 OH Primary

Addresses

Primary practice location

24911 Little Mack Ave
Saint Clair Shores, MI 48080-3200

Mailing address

24911 Little Mack Ave
Saint Clair Shores, MI 48080-3200
Phone (586) 777-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723004254 OH Practitioner - Family Practice 2163819954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oakland Univ, William Beaumont School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5850 Landerbrook Dr
Suite 100
Mayfield HTS, OH 44124-4071
Phone (216) 383-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.153946OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince May 16, 2025 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Family Medicine CurrentSince May 16, 2025 Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

5850 Landerbrook Dr
Ste 100
Mayfield Hts, OH 44124
Phone (216) 646-2200

Interoperability endpoints

  • Direct secure messaging: mbecker1116885@direct.hfhs.org

Organizations & group practices 5

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 8

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1154070647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24911 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803200",
            "telephone_number": "586-777-2050",
            "fax_number": "586-777-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24911 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803200",
            "telephone_number": "586-777-2050",
            "fax_number": "586-777-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "MITCHELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.153946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.