Opdyke Medical, PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

OPDYKE MEDICAL, PLLC

Practice address

3959 Centerpoint Pkwy Ste 100
Pontiac, MI 48341-3121

Phone

(248) 333-2600

Fax

(248) 333-3250

NPI assigned

Apr 3, 2013

Organization subpart

No

Name

Marie Therese Crum

Title

Administrator

Phone

(248) 240-5699

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

• Nada Samir Beydoun, D.O

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1912293978

  Internal Medicine, MI

  Medicare reassignment NPD
• Sarah Elizabeth Cole, FNP-C

  • Family Nurse Practitioner
  • Pontiac, MI
  • NPI 1588040455

  Family

  NPD
• Paul Walter Haduck, DO

  • Family Medicine Physician
  • Munising, MI
  • NPI 1679587174
  NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10065479

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 13, 2023.

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1154664688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 CENTERPOINT PKWY STE 100",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483413121",
            "telephone_number": "248-333-2600",
            "fax_number": "248-333-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 CENTERPOINT PKWY STE 100",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483413121",
            "telephone_number": "248-333-2600",
            "fax_number": "248-333-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPDYKE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "CRUM",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-240-5699"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2805350",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mohamad Yser Orabi, MD
• Sarah Katie Ornazian, D.O.

• All providers in Pontiac, MI
• Multi-Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.