NPIMap

Organization Active NPI

ENT Surgical Assoc PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Madison Heights, MI
National Provider Identifier
1225073687
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
Legal business name
ENT SURGICAL ASSOC PC
Practice address
27483 Dequindre Rd Ste 201
Madison Heights, MI 48071-5711
Phone
(248) 541-0100
Fax
(248) 399-3960
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Authorized official

Name
Dr. Warren L Brandes, DONPI 1285613364
Title
Ceo President
Phone
(248) 541-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0602X
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0905X Primary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X
Hearing Instrument SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 237700000X

Addresses

Primary practice location

27483 Dequindre Rd Ste 201
Madison Heights, MI 48071-5711

Mailing address

27483 Dequindre Rd Ste 201
Madison Heights, MI 48071-5711
Phone (248) 541-0100

Other identifiers 1

IdentifierTypeStateIssuer
040F31200OtherMIBCBS MI

National Provider Directory

National Provider Directory

Locations

486 Cadieux Rd
Grosse Pointe Park, MI 48230
Phone (313) 343-1000

27483 Dequindre Rd
Ste 2
Madison Heights, MI 48071

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1225073687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27483 DEQUINDRE RD STE 201",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480715711",
            "telephone_number": "248-541-0100",
            "fax_number": "248-399-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27483 DEQUINDRE RD STE 201",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480715711",
            "telephone_number": "248-541-0100",
            "fax_number": "248-399-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT SURGICAL ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "BRANDES",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "248-541-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "040F31200",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.