Beaumont Medical Group-Primary Care Services

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BEAUMONT MEDICAL GROUP-PRIMARY CARE SERVICES

Practice address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Phone

(248) 898-5000

NPI assigned

Sep 28, 2017

Last updated

Apr 7, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Scott Maner

Title

Sr. VP Beaumont Physician Partners

Phone

(947) 522-1912

Specialties & licenses 1

Addresses

Locations

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aleksandr Archiyan, DO

  • Family Medicine Physician
  • Warren, MI
  • NPI 1275945156
  NPD (past)
• Lucy Boekelheide, M.D.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1255710430
  NPD (past)
• Oneil Doha, MD

  • Family Medicine Physician
  • Roseville, MI
  • NPI 1184281248
  NPD (past)
• Valerie Ann Efros, MD

  • Family Medicine Physician
  • Roseville, MI
  • NPI 1336631282
  NPD (past)
• John Kaoru Geddes, MD, PHD

  • Family Medicine Physician
  • Roseville, MI
  • NPI 1962995480
  NPD (past)
• Wafaa S. Hanna, M.D.

  • Internal Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1114929106
  NPD (past)
• Dana Georgeta Kerges, M.D.

  • Family Medicine Physician
  • Warren, MI
  • NPI 1487620050
  NPD (past)
• Kristin Alexis Kops, DO

  • Family Medicine Physician
  • Hazel Park, MI
  • NPI 1376100206
  NPD (past)
• Andrew Harry Kotsis, D.O.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1346428802
  NPD (past)
• Leia Ruth Meyers, M.D.

  • Family Medicine Physician
  • Warren, MI
  • NPI 1841291184
  NPD (past)
• Faith Maria Miegoc, PA-C

  • Physician Assistant
  • Rochester Hills, MI
  • NPI 1225622525
  NPD (past)
• Andrew William James Moore, DO

  • Family Medicine Physician
  • Roseville, MI
  • NPI 1275224065
  NPD (past)

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1215446646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BOULEVARD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT MEDICAL GROUP-PRIMARY CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "MANER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "SR. VP BEAUMONT PHYSICIAN PARTNERS",
        "authorized_official_telephone_number": "947-522-1912"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beaumont Health System
• Beaumont Health System
• Beaumont Medical Group Hospital -Based Services
• Beaumont Medical Group- Specialty Services
• Beaumont Medical Group- Specialty Services
• Beaumont Orthopaedic Center
• Beaumont Special Radiological Procedures
• Beaumont Weight Control Center
• Damanpreet Singh Bedi, M.D.
• Alisa Bednar, M.A., CCC-SLP

• Family Medicine Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.