NPIMap

Organization Active NPI

Longevity Clinical LTC Associates of Michigan PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Dearborn Heights, MI
National Provider Identifier
1154992196
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
LONGEVITY CLINICAL LTC ASSOCIATES OF MICHIGAN PLLC
Practice address
26505 Powers Ave
Dearborn Heights, MI 48125-1327
Phone
(313) 291-6200
NPI assigned
Jul 9, 2021
Last updated
Mar 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
Michelle Byowitz
Title
Provider Relations Representative
Phone
(561) 850-4129

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

26505 Powers Ave
Dearborn Heights, MI 48125-1327

Mailing address

11770 US Highway 1 Ste 102E
Palm Beach Gardens, FL 33408-3052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210916001736 MI Part B Supplier - Clinic/Group Practice 5395142442 Receives reassigned benefits from 17 practitioners
Practice locations: Plymouth, MI; Rose City, MI; Southfield, MI; Taylor, MI; Traverse City, MI; Warren, MI; West Bloomfield, MI; West Branch, MI…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1154992196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 US HIGHWAY 1 STE 102E",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334083052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26505 POWERS AVE",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251327",
            "telephone_number": "313-291-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY CLINICAL LTC ASSOCIATES OF MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "BYOWITZ",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PROVIDER RELATIONS REPRESENTATIVE",
        "authorized_official_telephone_number": "561-850-4129"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.