NPIMap

Organization Active NPI

Huron Gastroenterology Associates PC

  • Gastroenterology Physician
  • Howell, MI
National Provider Identifier
1265635593
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
HURON GASTROENTEROLOGY ASSOCIATES PC
Practice address
620 Byron Rd
Howell, MI 48843-1002
Phone
(734) 434-6262
Fax
(734) 712-2820
NPI assigned
Jun 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Lana Cooper
Title
Administrator
Phone
(734) 528-1405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

620 Byron Rd
Howell, MI 48843-1002

Mailing address

5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone (734) 434-6262

Other identifiers 2

IdentifierTypeStateIssuer
CE4308OtherMIMEDICARE RAILROAD GROUP
10H14989OtherMIBCBS GROUP

Other names 1

  • Huron Gastro Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040504001055 MI Part B Supplier - Clinic/Group Practice 0840288221 Receives reassigned benefits from 127 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chelsea, MI; Canton, MI; Ypsilanti, MI; Howell, MI; Livonia, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 113

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 113

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1265635593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632",
            "telephone_number": "734-434-6262",
            "fax_number": "734-712-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BYRON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431002",
            "telephone_number": "734-434-6262",
            "fax_number": "734-712-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON GASTROENTEROLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "734-528-1405"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "CE4308",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "10H14989",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huron Gastro",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.