NPIMap

Organization Active NPI

Bloomfield Medical Center PLC

  • Clinic/Center
  • Farmington Hills, MI
National Provider Identifier
1265523328
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BLOOMFIELD MEDICAL CENTER PLC
Practice address
23900 Orchard Lake Rd
Suite 150
Farmington Hills, MI 48336-2501
Phone
(248) 203-1282
Fax
(248) 203-4148
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Authorized official

Name
Rene Weeks
Title
Billing/Credentialing Manager
Phone
(248) 203-1282

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

23900 Orchard Lake Rd
Suite 150
Farmington Hills, MI 48336-2501

Mailing address

PO Box 32588
Detroit, MI 48232-0588
Phone (248) 203-1282

Other identifiers 2

IdentifierTypeStateIssuer
104426188MedicaidMI
104796788MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000379 MI Part B Supplier - Clinic/Group Practice 1153235742 Receives reassigned benefits from 6 practitioners
Practice locations: Farmington Hills, MI

National Provider Directory

National Provider Directory

Locations

19141 Greenfield Rd
Ste B
Detroit, MI 48235

19141 Greenfield Rd
Ste A
Detroit, MI 48235

13900 Woodward Ave
Highland Park, MI 48203
Phone (248) 538-8030

7479 Middlebelt Rd
West Bloomfield, MI 48322
Phone (248) 855-9141

Practitioners & affiliated clinicians

Practitioners 10

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1265523328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32588",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482320588",
            "telephone_number": "248-203-1282",
            "fax_number": "248-203-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23900 ORCHARD LAKE RD",
            "address_2": "SUITE 150",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362501",
            "telephone_number": "248-203-1282",
            "fax_number": "248-203-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD MEDICAL CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "248-203-1282"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104426188",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104796788",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.