MMG 1 PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MMG 1 PC

Doing business as

Millennium Diagnostic Center

Practice address

32255 Northwestern Hwy Ste 100
Farmington Hills, MI 48334-1573

Phone

(248) 945-0000

Fax

(248) 945-1819

NPI assigned

Feb 11, 2009

Last updated

Sep 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Geoffrey A. Trivax, M.D.NPI 1164407730

Title

President

Phone

(248) 354-9666

Specialties & licenses 8

Addresses

Other names 1

• MILLENNIUM DIAGNOSTIC CENTER Doing business as

Tax ID family

MMG 1PC5 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.

• MMG 1PC

  dba Neurological Consultants

  • Neurology Physician
  • Southfield, MI
  • NPI 1184878001
  NPD tax ID
• MMG 1PC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1215040506
  NPD tax ID
• MMG 1PC

  dba Northwest Internal Medicine

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1215103940
  NPD tax ID
• MMG 1PC

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1881714723
  NPD tax ID

Practitioners 2

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.

• Geoffrey Trivax, M.D.

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1164407730
  Authorized official Same address or phone
• Jeffrey F Parker, M.D.

  • Internal Medicine Physician
  • Eureka, CA
  • NPI 1689650889
  NPD (past)

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1285873430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32255 NORTHWESTERN HWY STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341573",
            "telephone_number": "248-945-0000",
            "fax_number": "248-945-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG 1 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "TRIVAX",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-354-9666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLENNIUM DIAGNOSTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MILLENNIUM DIAGNOSTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rushanda Mize
• Andrew Vincent Mizzi, DO
• Howa Mkoma
• Mohamed Mkoma
• Sarafina Mmbaga
• MMG 1 PC (Millenium Diagnostic Center)
• MMG 1 PC (Internal Medicine Physicians)
• Solace Mngo
• Peter Moa
• Shelbi Moats

• Diagnostic Radiology Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.