NPIMap

Individual provider Active NPI

Michael George Taylor, MD

  • Surgery Physician
  • St Clair Shores, MI
National Provider Identifier
1154363240
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
405365 Issued in MI
Practice address
22646 Nine Mile Road
Ste C
St Clair Shores, MI 48080-1951
Phone
(586) 443-5400
Fax
(586) 443-5403
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 405365 MI Primary

Addresses

Primary practice location

22646 Nine Mile Road
Ste C
St Clair Shores, MI 48080-1951

Mailing address

24535 Jefferson Ave
Ste C
Saint Clair Shores, MI 48080-2898
Phone (586) 443-5400

Other identifiers 1

IdentifierTypeStateIssuer
4134989MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050307000133 MI Practitioner - General Surgery 5395638506 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgeons PCGroup PAC ID 6002956265, 15 clinicians

Practice addresses (Care Compare)

Southfield, MI 48075
Phone (248) 849-3000

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

24535 Jefferson Ave
Saint Clair Shores, MI 48080-2898
Phone (586) 443-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue16
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
405365MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Surgery CurrentSince Feb 27, 2012 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Feb 27, 2012 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Acute Care Surgeons PC CurrentSince Nov 14, 2009 Accepting new patients
Critical Care Surgeons PLLC Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22201 Moross Rd
Ste 150
Grosse Pointe, MI 48236
Phone (313) 343-7110

Interoperability endpoints

  • Direct secure messaging: mtaylor1155296@direct.hfhs.org

Organizations & group practices 7

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 6

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1154363240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24535 JEFFERSON AVE",
            "address_2": "STE C",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802898",
            "telephone_number": "586-443-5400",
            "fax_number": "586-443-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22646 NINE MILE ROAD",
            "address_2": "STE C",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801951",
            "telephone_number": "586-443-5400",
            "fax_number": "586-443-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "405365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4134989",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.