NPIMap

Organization Active NPI

Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
National Provider Identifier
1225022288
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
Legal business name
BARBARA ANN KARMANOS CANCER INSTITUTE
Practice address
4100 John R Road
Detroit, MI 48201-1312
Phone
(800) 527-6266
Fax
(248) 827-7663
NPI assigned
Sep 7, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. William G. Bennett, CFO
Title
Chief Finance Officer
Phone
(248) 827-4580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X NU Primary

Addresses

Primary practice location

4100 John R Road
Detroit, MI 48201-1312

Mailing address

24601 Northwestern Hwy
Attention Diane Baroky
Southfield, MI 48075-2473
Phone (248) 827-4580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000601 MI Part B Supplier - Clinic/Group Practice 3870407901 Receives reassigned benefits from 136 practitioners
1 other NPI on this enrollment
Practice locations: Bloomfield Hills, MI; Dearborn, MI; Detroit, MI; Farmington Hills, MI; Livonia, MI; Roseville, MI; Southfield, MI

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

28105 Woodward Ave
Berkley, MI 48072
Phone (248) 543-7982

110 E Warren Ave
Detroit, MI 48201
Phone (313) 833-0715

30550 Utica Rd
Roseville, MI 48066
Phone (586) 771-0290

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Karmanos Cancer CenterDetroit, MI, CCN 230297 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 20, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 160

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.

View all 160

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225022288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24601 NORTHWESTERN HWY",
            "address_2": "ATTENTION DIANE BAROKY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752473",
            "telephone_number": "248-827-4580",
            "fax_number": "248-827-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ROAD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011312",
            "telephone_number": "800-527-6266",
            "fax_number": "248-827-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARBARA ANN KARMANOS CANCER INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CHIEF FINANCE OFFICER",
        "authorized_official_telephone_number": "248-827-4580",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.