Meadowbrook Primary Care, PLLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

MEADOWBROOK PRIMARY CARE, PLLC

Practice address

2050 N Haggerty Rd Ste 260
Canton, MI 48187-3796

Phone

(734) 892-2712

Fax

(734) 892-2714

NPI assigned

Feb 13, 2015

Organization subpart

No

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

Authorized official

Name

Sarju Shah, M.D.

Title

Owner / President

Phone

(734) 892-2712

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 7

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

• Jamie Fineran, NP

  • Family Nurse Practitioner
  • Garden City, MI
  • NPI 1366953473
  Medicare reassignment Care Compare group NPD
• Salman Younas Khan, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1043690183

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Heidi Harmony Romero, NP

  • Nurse Practitioner
  • Wayne, MI
  • NPI 1417483678
  Medicare reassignment Care Compare group NPD
• James Robert Tisius III, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1609122084
  Medicare reassignment Care Compare group NPD
• Russell Miller, CNP

  • Gerontology Nurse Practitioner
  • Shelby Township, MI
  • NPI 1013455922
  Medicare reassignment NPD
• Falgun C. Patel, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1932319415
  Medicare reassignment NPD
• Robyn Leigh Dragoo, O.D.

  • Optometrist
  • Novi, MI
  • NPI 1952426298
  NPD

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1154712073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 N HAGGERTY RD STE 260",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873796",
            "telephone_number": "734-892-2712",
            "fax_number": "734-892-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 N HAGGERTY RD STE 260",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873796",
            "telephone_number": "734-892-2712",
            "fax_number": "734-892-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWBROOK PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SARJU",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "734-892-2712",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise M McNulty, LMSW
• Mary Leadith McNulty, N.P.
• Kristina McRae
• Nowanna McWhirter, LPN
• Theresa Meador, C.T.R.S.
• Meah Counseling, LLC
• Medicure Supply LLC
• Sandra Maria Medley
• Medstar Rehabilitation Inc.
• Kathleen Selam Mehari, M.D.

• Nursing Care Agency in Canton, MI
• Providers in Canton, MI by specialty
• Nursing Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.