NPIMap

Organization Active NPI

Gi Medical Assoc PC

  • Gastroenterology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1154311405
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GI MEDICAL ASSOC PC
Practice address
28963 Little Mack Ave
Suite 101
Saint Clair Shores, MI 48081-3017
Phone
(586) 447-0700
Fax
(586) 498-0707
NPI assigned
Oct 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Katrina Nicole Ciluffo
Title
Practice Administrator
Phone
(586) 445-3719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

28963 Little Mack Ave
Suite 101
Saint Clair Shores, MI 48081-3017

Mailing address

28963 Little Mack Ave Ste 101
Saint Clair Shores, MI 48081-3017
Phone (586) 447-0700

Other practice location 1

17900 23 Mile Rd Ste 404
Macomb, MI 48044-1161
Phone (586) 447-0700

Other names 1

  • GI MEDICINE ASSOCIATES PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603001029 MI Part B Supplier - Clinic/Group Practice 3375525215 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
Practice locations: Saint Clair Shores, MI; Macomb, MI

National Provider Directory

National Provider Directory

Locations

13350 24 Mile Rd
Ste 100
Shelby Township, MI 48315
Phone (586) 991-8750

28963 Little Mack Ave
St Clr Shores, MI 48081

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1154311405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK AVE STE 101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813017",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK AVE",
            "address_2": "SUITE 101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813017",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17900 23 Mile Rd Ste 404",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480441161",
            "country_code": "US",
            "telephone_number": "586-447-0700",
            "fax_number": "586-447-0795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GI MEDICAL ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "CILUFFO",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "586-445-3719"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GI MEDICINE ASSOCIATES PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.