NPIMap

Organization Active NPI

Critical Care Medicine Associates PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Dearborn, MI
National Provider Identifier
1235219403
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
CRITICAL CARE MEDICINE ASSOCIATES PC
Practice address
18181 Oakwood Blvd
Suite 208
Dearborn, MI 48124-5032
Phone
(313) 271-5565
Fax
(313) 271-1053
NPI assigned
Oct 16, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Tracy A Coleman
Title
Ceo, Physicianlinx LLC
Phone
(313) 563-3332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X Primary

Addresses

Primary practice location

18181 Oakwood Blvd
Suite 208
Dearborn, MI 48124-5032

Mailing address

3200 Greenfield Rd
Suite 250
Dearborn, MI 48120-1802
Phone (313) 563-3332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060106000541 MI Part B Supplier - Clinic/Group Practice 4789607557 Receives reassigned benefits from 14 practitioners
Practice locations: Dearborn, MI; Wyandotte, MI; Wayne, MI; Taylor, MI

National Provider Directory

National Provider Directory

Locations

24775 Haig St
Taylor, MI 48180
Phone (313) 295-5000

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1235219403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GREENFIELD RD",
            "address_2": "SUITE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201802",
            "telephone_number": "313-563-3332",
            "fax_number": "313-563-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "SUITE 208",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-271-5565",
            "fax_number": "313-271-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITICAL CARE MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO, PHYSICIANLINX LLC",
        "authorized_official_telephone_number": "313-563-3332"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.