Individual provider Active NPI

Trpko Dimovski, MD

  • Family Medicine Physician
  • Shelby Township, MI
National Provider Identifier
1205885399
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301051487 Issued in MI
Practice address
15055 22 Mile Rd
Suite 3
Shelby Township, MI 48315-4401
Phone
(586) 566-7100
Fax
(586) 566-8088
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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 4301051487 MI Primary

Addresses

Primary practice location

15055 22 Mile Rd
Suite 3
Shelby Township, MI 48315-4401

Mailing address

15055 22 Mile Rd
Suite 3
Shelby Township, MI 48315-4401
Phone (586) 566-7100

Other identifiers 1

IdentifierTypeStateIssuer
4373816MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000144 MI Practitioner - Family Practice 0941283931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians

Practice addresses (Care Compare)

15055 22 Mile Rd
Suite 3
Shelby TWP, MI 48315-4401
Phone (586) 566-7100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301051487MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

13350 24 Mile Rd
Ste 200
Shelby Township, MI 48315
Phone (586) 566-7100

15055 22 Mile Rd
Ste 3
Shelby Township, MI 48315
Phone (586) 566-7100

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: trpko.dimovski.2@8209.direct.athenahealth.com
  • Direct secure messaging: tdimovski241789@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1205885399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15055 22 MILE RD",
            "address_2": "SUITE 3",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154401",
            "telephone_number": "586-566-7100",
            "fax_number": "586-566-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15055 22 MILE RD",
            "address_2": "SUITE 3",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154401",
            "telephone_number": "586-566-7100",
            "fax_number": "586-566-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMOVSKI",
        "first_name": "TRPKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301051487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4373816",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.