Active NPI
Great Physicians, PC
- Family Medicine Physician
- Troy, MI
National Provider Identifier
1174286017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- GREAT PHYSICIANS, PC
- Doing business as
- Carecore Health Center
- Practice address
- 5032 Rochester Rd Ste 200
Troy, MI 48085-3454 - Phone
- (248) 250-9029
- Fax
- (248) 250-9733
- NPI assigned
- Oct 18, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Olivia Pass
- Title
- Credentialing Manager
- Phone
- (248) 820-1712
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
5032 Rochester Rd Ste 200
Troy, MI 48085-3454
Mailing address
909 E Maple St
Holly, MI 48442-1755
Phone (248) 820-1712
Other names 1
- Carecore Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2240462 | Carecore Health Center | Certificate of waiver | Oct 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
5032 Rochester Rd
Troy, MI 48085
Phone 2482150048101
5032 Rochester Rd
Ste 200
Troy, MI 48085
Phone (248) 250-6373
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1634515200000",
"number": "1174286017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 E MAPLE ST",
"city": "HOLLY",
"state": "MI",
"postal_code": "484421755",
"telephone_number": "248-820-1712",
"fax_number": "248-469-0966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5032 ROCHESTER RD STE 200",
"city": "TROY",
"state": "MI",
"postal_code": "480853454",
"telephone_number": "248-250-9029",
"fax_number": "248-250-9733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT PHYSICIANS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-18",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A",
"authorized_official_last_name": "PASS",
"authorized_official_first_name": "OLIVIA",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "248-820-1712"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Carecore Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.