NPIMap

Individual provider Active NPI

Gregory B Koby, D.O.

  • Family Medicine Physician
  • Shelby Township, MI
National Provider Identifier
1164474078
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013537 Issued in MI
Practice address
8180 26 Mile Rd
Shelby Township, MI 48316-5129
Phone
(586) 677-3310
Fax
(586) 677-3326
NPI assigned
May 17, 2006
Last updated
Oct 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013537 MI Primary

Addresses

Primary practice location

8180 26 Mile Rd
Shelby Township, MI 48316-5129

Mailing address

6000 24 Mile Rd
Shelby Township, MI 48316-3201
Phone (586) 677-3310

Other identifiers 4

IdentifierTypeStateIssuer
CD3610 POO374817OtherMIMETRAHEALTH
080E020640OtherMIBCBS
OP48400001OtherMIMEDICARE GROUP
1022827OtherMIMHP HAN

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
I20070215000389 MI Practitioner - Family Practice 4082616339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Partners in Family Medicine, PLLCGroup PAC ID 4688769516, 3 clinicians

Practice addresses (Care Compare)

44003 Partridge Creek Blvd
Clinton TWP, MI 48038-0002
Phone (342) 627-3267

6000 24 Mile Rd
Shelby Township, MI 48316-3201
Phone (586) 884-6702

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101013537MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Family Medicine, PLLC Family Medicine CurrentSince Oct 1, 2007 Accepting new patients

Locations

6000 24 Mile Rd
Shelby Township, MI 48316
Phone (586) 677-3310

8180 26 Mile Rd
Shelby Township, MI 48316
Phone (810) 286-4880

Interoperability endpoints

  • Direct secure messaging: gregorykoby@pifmedic.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1164474078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 24 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163201",
            "telephone_number": "586-677-3310",
            "fax_number": "586-677-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 26 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165129",
            "telephone_number": "586-677-3310",
            "fax_number": "586-677-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBY",
        "first_name": "GREGORY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRAHEALTH",
            "identifier": "CD3610 POO374817",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "080E020640",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "OP48400001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHP HAN",
            "identifier": "1022827",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.