Organization Active NPI

Institute of Neuromuscular Medicine

  • Neuromusculoskeletal Medicine & OMM Physician
  • Detroit, MI
National Provider Identifier
1285717249
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
Legal business name
INSTITUTE OF NEUROMUSCULAR MEDICINE
Practice address
4300 Marseilles St
Detroit, MI 48224-1479
Phone
(313) 290-2250
Fax
(313) 290-2257
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Hardik Shah, DONPI 1508852765
Title
Owner
Phone
(313) 290-2250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204D00000X Primary

Addresses

Primary practice location

4300 Marseilles St
Detroit, MI 48224-1479

Mailing address

4300 Marseilles St
Detroit, MI 48224-1479
Phone (313) 290-2250

Other identifiers 2

IdentifierTypeStateIssuer
0855010684OtherMIBCBSM
1508852765MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110525000660 MI Part B Supplier - Clinic/Group Practice 6002092160 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Locations

4300 Marseilles St
Detroit, MI 48224
Phone (313) 290-2250

Practitioners & affiliated clinicians

Practitioners 1

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": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1285717249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARSEILLES ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241479",
            "telephone_number": "313-290-2250",
            "fax_number": "313-290-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARSEILLES ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241479",
            "telephone_number": "313-290-2250",
            "fax_number": "313-290-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF NEUROMUSCULAR MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "HARDIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-290-2250",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0855010684",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508852765",
            "state": "MI"
        }
    ],
    "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 Apr 6, 2026; 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.