Individual provider Active NPI

Michael Dubose

  • Social Worker
  • Sterling Heights, MI
National Provider Identifier
1265977128
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801099305 Issued in MI
Practice address
5725 Newberry Dr
Apt 201
Sterling Heights, MI 48310-7434
Phone
(313) 918-8304
NPI assigned
Jan 3, 2017
Last updated
Jan 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801099305 MI Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

5725 Newberry Dr
Apt 201
Sterling Heights, MI 48310-7434

Mailing address

5725 Newberry Dr
Apt 201
Sterling Heights, MI 48310-7434
Phone (313) 918-8304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128004102 MI Practitioner - Clinical Social Worker 7810426426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Warren, MI 48093
Phone (586) 393-9710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801099305MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Caring Approach LLC Clinical CurrentSince Nov 16, 2024 Accepting new patients
A Restored Outlook LLC Clinical CurrentSince Nov 17, 2019 Accepting new patients
Macomb County Community Mental Health Services Past Accepting new patients

Locations

15001 Kercheval Ave
Grosse Pointe Park, MI 48230
Phone (313) 263-7245

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1265977128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 NEWBERRY DR",
            "address_2": "APT 201",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483107434",
            "telephone_number": "313-918-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 NEWBERRY DR",
            "address_2": "APT 201",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483107434",
            "telephone_number": "313-918-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801099305",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.