NPIMap

Individual provider Active NPI

Mark Pressprich

  • Urology Physician
  • Brownstown TWP, MI
National Provider Identifier
1194288944
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301511048 Issued in MI
Practice address
19117 Allen Rd Ste a
Brownstown TWP, MI 48183-1066
Phone
(734) 676-4040
Fax
(734) 676-9897
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301511048 MI Primary

Addresses

Primary practice location

19117 Allen Rd Ste a
Brownstown TWP, MI 48183-1066

Mailing address

20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

Other practice location 1

18100 Oakwood Blvd Ste 315
Dearborn, MI 48124-4085
Phone (313) 271-0066

Other identifiers 2

IdentifierTypeStateIssuer
1194288944MedicaidMI
4301511048OtherMIMI MEDICAL LICENSE

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
I20240506000640 MI Practitioner - Urology 9234579426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians

Practice addresses (Care Compare)

19117 Allen Rd
Suite a
Brownstown TWP, MI 48183-1066
Phone (734) 676-4040

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Corewell Health Trenton Hospital Hospital, Trenton, MI, CCN 230176
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270
  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301511048MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Jun 17, 2024 Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Jun 17, 2024 Accepting new patients

Locations

19117 Allen Rd
#A
Brownstown Twp, MI 48183
Phone (734) 675-0835

18100 Oakwood Blvd
Ste 315
Dearborn, MI 48124
Phone (313) 271-0066

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

Organizations & group practices 2

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

Hospital & facility affiliations 9

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1194288944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19117 ALLEN RD STE A",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831066",
            "telephone_number": "734-676-4040",
            "fax_number": "734-676-9897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18100 Oakwood Blvd Ste 315",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244085",
            "country_code": "US",
            "telephone_number": "313-271-0066",
            "fax_number": "313-271-1047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESSPRICH",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301511048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194288944",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI MEDICAL LICENSE",
            "identifier": "4301511048",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown TWP, MI

Sources for this page

Verify at the official NPI Registry.