NPIMap

Organization Active NPI

Avocare Health Services

  • Geriatric Medicine (Family Medicine) Physician
  • Dearborn, MI
National Provider Identifier
1154156420
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
AVOCARE HEALTH SERVICES
Practice address
6 Parklane Blvd Ste 525
Dearborn, MI 48126-4210
Phone
(810) 275-1885
Fax
(810) 391-2263
NPI assigned
Sep 5, 2024
Last updated
Sep 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
AVOCARE HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
John Hillary
Title
Cfo
Phone
(810) 275-1885

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X NU
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

6 Parklane Blvd Ste 525
Dearborn, MI 48126-4210

Mailing address

6 Parklane Blvd Ste 525
Dearborn, MI 48126-4210
Phone (810) 275-1885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240509003279 MI Part B Supplier - Clinic/Group Practice 2668838038 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Dearborn, 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
Avocare Health Services2 organizations share this tax ID, including this one
Part of
Avocare Health Services

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1154156420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD STE 525",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264210",
            "telephone_number": "810-275-1885",
            "fax_number": "810-391-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD STE 525",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264210",
            "telephone_number": "810-275-1885",
            "fax_number": "810-391-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVOCARE HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVOCARE HEALTH SERVICES",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "HILLARY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "810-275-1885"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.