Crista Broutin, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101015704 Issued in MI

Practice address

36123 Schoolcraft Rd
Livonia, MI 48150-1216

Phone

(734) 464-0887

Fax

(734) 402-0254

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Michigan State University College of Osteopathic Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inpatient Consultants of Michigan PCGroup PAC ID 6709891286, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Hospice Hospice, Davison, MI, CCN 231521
• McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inpatient Consultants of Michigan PC

  • Hospitalist Physician
  • Livonia, MI
  • NPI 1861442824

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Michigan PC

  • Hospitalist Physician
  • Livonia, MI
  • NPI 1891000964

  Internal Medicine

  NPD
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Health Management Group

  • Community Based Hospice Care Agency
  • Davison, MI
  • NPI 1629011168
  Care Compare affiliation
• McLaren Macomb

  • Psychiatric Hospital Unit
  • Shelby Township, MI
  • NPI 1184206385
  Care Compare affiliation
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327
  Care Compare affiliation
• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1265537625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUTIN",
        "first_name": "CRISTA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101015704",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "5101015704",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CPIN #",
            "identifier": "70-0-F32947-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CB015704",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1265537625",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4955211-11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Brooks
• Samantha Brooks
• Taliyah Brooks
• Amealeyon Brothers
• Arthur Brouk
• Caroleena Brown Carlton
• Brenni Brown-Polanski, CRNA
• Autumn Brown
• Carmen Brown
• D'Nisha Ijahnae Brown

• Internal Medicine Physician in Livonia, MI
• Providers in Livonia, 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 Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.