Organization Active NPI

Michigan Surgery Specialists, P.C.

  • Surgery Physician
  • Warren, MI
National Provider Identifier
1184828451
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MICHIGAN SURGERY SPECIALISTS, P.C.
Practice address
11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546
Phone
(586) 751-3380
Fax
(586) 751-0950
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Michele L Kudlor
Title
Billing Manager
Phone
(586) 459-5592

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Surgery of the Hand (Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0105X

Addresses

Primary practice location

11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546

Mailing address

31201 Chicago Rd S Ste C302
Warren, MI 48093-5553
Phone (586) 582-0864

Other practice location 1

14650 E Old US Highway 12 Ste 302
Chelsea, MI 48118-1805
Phone (586) 582-0864

Other practice location 2

19725 Allen Rd Ste A
Brownstown Twp, MI 48183-1090
Phone (586) 751-3380

Other practice location 3

22731 Newman St Ste 100A
Dearborn, MI 48124-2031
Phone (313) 561-4910

Other practice location 4

37650 Professional Center Dr
Livonia, MI 48154-1197
Phone (734) 943-3838

Other practice location 5

11012 E 13 Mile Rd Ste 201
Warren, MI 48093-2547
Phone (586) 582-0760

Other practice location 6

11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546
Phone (585) 573-6880

Other practice location 7

32300 Northwestern Hwy Ste 200
Farmington Hills, MI 48334-1501
Phone (586) 573-6880

Other practice location 8

50505 Schoenherr Rd Ste 120
Shelby Township, MI 48315-3140
Phone (855) 450-2020

Other practice location 9

11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546
Phone (586) 582-0864

Other practice location 10

25500 Meadowbrook Rd Ste 275
Novi, MI 48375-1884
Phone (248) 516-3519

Other practice location 11

3100 Cross Creek Pkwy Ste 150
Auburn Hills, MI 48326-2777
Phone (248) 475-0502

Other practice location 12

18245 E 10 Mile Rd Ste 130
Roseville, MI 48066-5807
Phone (586) 774-3100

Other identifiers 2

IdentifierTypeStateIssuer
700E063760OtherMIBCBS GROUP #
OEO6376OtherMIMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302001010 MI Part B Supplier - Clinic/Group Practice 7113835075 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
Practice locations: Novi, MI; Roseville, MI; Shelby Township, MI; Southfield, MI; Warren, MI; Farmington Hills, MI; Dearborn, MI; Chelsea, MI…

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

29900 Lorraine Ave
Ste 400
Warren, MI 48093

Ownership & related parties

Subparts reporting this organization as parent 20

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 20

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1184828451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S STE C302",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935553",
            "telephone_number": "586-582-0864",
            "fax_number": "586-582-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD STE 112",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932546",
            "telephone_number": "586-751-3380",
            "fax_number": "586-751-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14650 E Old US Highway 12 Ste 302",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MI",
            "postal_code": "481181805",
            "country_code": "US",
            "telephone_number": "586-582-0864",
            "fax_number": "586-513-3807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19725 Allen Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Brownstown Twp",
            "state": "MI",
            "postal_code": "481831090",
            "country_code": "US",
            "telephone_number": "586-751-3380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22731 Newman St Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481242031",
            "country_code": "US",
            "telephone_number": "313-561-4910",
            "fax_number": "313-561-8561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37650 Professional Center Dr",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481541197",
            "country_code": "US",
            "telephone_number": "734-943-3838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11012 E 13 Mile Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480932547",
            "country_code": "US",
            "telephone_number": "586-582-0760",
            "fax_number": "586-582-5729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11012 E 13 Mile Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480932546",
            "country_code": "US",
            "telephone_number": "585-573-6880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32300 Northwestern Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483341501",
            "country_code": "US",
            "telephone_number": "586-573-6880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50505 Schoenherr Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483153140",
            "country_code": "US",
            "telephone_number": "855-450-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11012 E 13 Mile Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480932546",
            "country_code": "US",
            "telephone_number": "586-582-0864",
            "fax_number": "586-582-0964",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25500 Meadowbrook Rd Ste 275",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751884",
            "country_code": "US",
            "telephone_number": "248-516-3519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 Cross Creek Pkwy Ste 150",
            "address_purpose": "LOCATION",
            "city": "Auburn Hills",
            "state": "MI",
            "postal_code": "483262777",
            "country_code": "US",
            "telephone_number": "248-475-0502",
            "fax_number": "248-475-0584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18245 E 10 Mile Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MI",
            "postal_code": "480665807",
            "country_code": "US",
            "telephone_number": "586-774-3100",
            "fax_number": "586-774-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIGAN SURGERY SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "KUDLOR",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "586-459-5592"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "700E063760",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "OEO6376",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.