Organization Active NPI

Tri County Endocrinology & Nuclear Medicine PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Warren, MI
National Provider Identifier
1255363388
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
TRI COUNTY ENDOCRINOLOGY & NUCLEAR MEDICINE PC
Practice address
14049 E 13 Mile Rd
Suite 6
Warren, MI 48088-5876
Phone
(586) 294-4820
Fax
(586) 294-7881
NPI assigned
Jul 7, 2006
Last updated
Jul 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Mrs. Elaine Rose Elandt
Title
Office Administrator
Phone
(586) 294-4820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Primary

Addresses

Primary practice location

14049 E 13 Mile Rd
Suite 6
Warren, MI 48088-5876

Mailing address

14049 E 13 Mile Rd
Suite 6
Warren, MI 48088-5876
Phone (586) 294-4820

Other identifiers 1

IdentifierTypeStateIssuer
0H26347OtherMIBCBS GRP NO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070719000442 MI Part B Supplier - Clinic/Group Practice 7618078734 Practice locations: Sterling Heights, MI

National Provider Directory

National Provider Directory

Locations

38731 Mound Rd
Sterling Hts, MI 48310
Phone (586) 939-8480

38731 Mound Rd
Ste 200
Sterling Hts, MI 48310
Phone (586) 939-8480

14049 E 13 Mile Rd
Ste 6
Warren, MI 48088
Phone (586) 294-4820

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1255363388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14049 E 13 MILE RD",
            "address_2": "SUITE 6",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480885876",
            "telephone_number": "586-294-4820",
            "fax_number": "586-294-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14049 E 13 MILE RD",
            "address_2": "SUITE 6",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480885876",
            "telephone_number": "586-294-4820",
            "fax_number": "586-294-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY ENDOCRINOLOGY & NUCLEAR MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "ELANDT",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "586-294-4820",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP NO",
            "identifier": "0H26347",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.