Individual provider Active NPI

Marc H Adelman, D.O.

  • Obstetrics & Gynecology Physician
  • Troy, MI
National Provider Identifier
1295728202
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101007155 Issued in MI
Practice address
4550 Investment Dr
Suite 200
Troy, MI 48098
Phone
(248) 643-7520
Fax
(248) 519-6004
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA007155 MI
Obstetrics & Gynecology Physician 207V00000X 5101007155 MI Primary

Addresses

Primary practice location

4550 Investment Dr
Suite 200
Troy, MI 48098

Mailing address

115 East Long Lake Road
Troy, MI 48085
Phone (248) 643-7520

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1043

Other practice location 2

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 712-4120

Other identifiers 1

IdentifierTypeStateIssuer
112914953MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address madelman20524@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101007155MIMDObstetrics & Gynecology Physician
MA007155MIMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: madelman20524@direct.beaumont.edu

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1295728202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 EAST LONG LAKE ROAD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48085",
            "telephone_number": "248-643-7520",
            "fax_number": "248-813-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 INVESTMENT DR",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48098",
            "telephone_number": "248-643-7520",
            "fax_number": "248-519-6004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-1043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-712-4120",
            "fax_number": "248-551-5010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADELMAN",
        "first_name": "MARC",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "MA007155",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101007155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112914953",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "madelman20524@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.