Individual provider Active NPI

Scott I Sircus, M.D.

  • Urology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1295724060
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301053931 Issued in MI
Practice address
20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone
(586) 771-4820
Fax
(586) 771-6620
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301053931 MI Primary

Addresses

Primary practice location

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200

Mailing address

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other practice location 1

3535 W 13 Mile Rd Ste 404
Royal Oak, MI 48073-6770
Phone (248) 551-3535

Other identifiers 5

IdentifierTypeStateIssuer
0783643OtherMICIGNA
4137015OtherMIAETNA
103474OtherMIPRIORITY HEALTH
E50390OtherMIHAP
P00321784OtherMIRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssircus104028@direct.beaumont.edu

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060615000231 MI Practitioner - Urology 8224057625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Miami, LM Miller School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

130 Town Ctr Dr
Troy, MI 48084-1744

19991 Hall Rd
Suite 201
Macomb, MI 48044-4254
Phone (586) 228-0150

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

33014 5 Mile Rd
Livonia, MI 48154-3075
Phone (734) 261-7401

37399 Garfield Rd
Suite 203
Clinton Township, MI 48036-3672
Phone (586) 228-2911

43650 Garfield Rd
Suite 102
Clinton Township, MI 48038-7419
Phone 58677148202072

5701 Bow Pointe Dr
Suite 250
Clarkston, MI 48346-5405
Phone (248) 620-6660

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301053931MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Macomb Urology CurrentSince Sep 1, 2014 Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Jul 10, 2006 Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Jul 10, 2006 Accepting new patients
Hall Road ASC LLC PastSince Nov 5, 2021 Accepting new patients

Locations

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

36500 S Gratiot Ave
Ste 102
Clinton Twp, MI 48035
Phone (586) 790-9003

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

Interoperability endpoints

  • Direct secure messaging: ssircus63267@direct.hfhs.org

Organizations & group practices 4

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295724060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 W 13 Mile Rd Ste 404",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736770",
            "country_code": "US",
            "telephone_number": "248-551-3535",
            "fax_number": "248-551-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRCUS",
        "first_name": "SCOTT",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301053931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0783643",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4137015",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "103474",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "E50390",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00321784",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssircus104028@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd Ste 404",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.