Primary Care Associates Group PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIMARY CARE ASSOCIATES GROUP PC

Practice address

22631 Greater Mack Ave
Saint Clair Shores, MI 48080-2055

Phone

(586) 800-0086

Fax

(586) 800-0087

NPI assigned

Jun 12, 2024

Last updated

Jun 12, 2024By 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

Diana El Masri

Title

Credentialor

Phone

(248) 215-0048

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 6

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.

• Amine Pierre Amine, M.D

  • Internal Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1861812828
  Medicare reassignment Care Compare group NPD
• Elizabeth Henson, FNP-BC

  • Family Nurse Practitioner
  • Northville, MI
  • NPI 1467164764
  Medicare reassignment Care Compare group NPD
• Scott Jenner

  • Nurse Practitioner
  • Eastpointe, MI
  • NPI 1063361343
  Medicare reassignment NPD
• Meghan Pasquali, FNP

  • Family Nurse Practitioner
  • Clawson, MI
  • NPI 1609587682
  Medicare reassignment NPD
• Kerrily Quay, RN,MSN,ACAGNP-BC

  • Nurse Practitioner
  • Wayne, MI
  • NPI 1043831910
  Medicare reassignment NPD
• Victoria Stark, PA-C

  • Medical Physician Assistant
  • Plymouth, MI
  • NPI 1902371735
  Medicare reassignment

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1235972860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22631 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802055",
            "telephone_number": "586-800-0086",
            "fax_number": "586-800-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22631 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802055",
            "telephone_number": "586-800-0086",
            "fax_number": "586-800-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ASSOCIATES GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "EL MASRI",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CREDENTIALOR",
        "authorized_official_telephone_number": "248-215-0048"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.