Organization Active NPI

Great Physicians, PC

  • Family Medicine Physician
  • Troy, MI
National Provider Identifier
1174286017
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on Oct 18, 2021

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211026002795 MI Part B Supplier - Clinic/Group Practice 4284022195 Receives reassigned benefits from 1 practitioner
Practice locations: Troy, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2240462Carecore Health Center5032 Rochester Road Suite 200, Troy, MI 48085Certificate of waiverOct 19, 2027

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.