NPIMap

Organization Active NPI

M Medical Mi PLLC

  • Pulmonary Disease Physician
  • Detroit, MI
National Provider Identifier
1275401440
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
M MEDICAL MI PLLC
Practice address
5201 Conner St
Detroit, MI 48213-3405
Phone
(313) 571-5555
NPI assigned
Oct 28, 2025
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Krystle D Brown
Title
Billing Manager
Phone
(410) 800-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

5201 Conner St
Detroit, MI 48213-3405

Mailing address

6 E Eager St
Baltimore, MD 21202-2506
Phone (410) 870-9380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH, KY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20250502002822 MI Part B Supplier - Clinic/Group Practice 6002332012 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Rapids, MI; Grandville, MI; Greenville, MI; Howell, MI; Kingsford, MI; Lamont, MI; Lansing, MI; Novi, MI…
O20250910003363 OH Part B Supplier - Clinic/Group Practice 6002332012 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tiffin, OH; Streetsboro, OH; Ontario, OH; Huron, OH; Norwalk, OH; New London, OH; Napoleon, OH; Mansfield, OH…
O20260518000528 KY Part B Supplier - Clinic/Group Practice 6002332012 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Grayson, KY; South Shore, KY; Wurtland, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Tax ID family
M Medical Mi PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

182 Saint Francis Ave
Tiffin, OH 44883
Phone (419) 447-2723

54 S Washington St
Tiffin, OH 44883
Phone (419) 447-6885

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1275401440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E EAGER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022506",
            "telephone_number": "410-870-9380",
            "fax_number": "410-431-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 CONNER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133405",
            "telephone_number": "313-571-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M MEDICAL MI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "410-800-6251"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.