NPIMap

Organization Active NPI

Alliance Physician Services of Michigan, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Troy, MI
National Provider Identifier
1295817799
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ALLIANCE PHYSICIAN SERVICES OF MICHIGAN, P.C.
Practice address
130 Town Center Drive
Suite 101
Troy, MI 48084-1773
Phone
(248) 740-0670
Fax
(248) 740-0668
NPI assigned
Oct 20, 2006
Organization subpart
Yes
Parent organization
ALLIANCE PHYSICIAN SERVICES OF MICHIGAN, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Tracy Lee McAuley
Title
Credentialing Supervisor
Phone
(586) 771-4820

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X
Pediatric Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2088P0231X
Non-Pharmacy Dispensing Site 332900000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

130 Town Center Drive
Suite 101
Troy, MI 48084-1773

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
340E062730OtherMIBCBSM
CB9133OtherMIRAILROAD MEDICARE
540E016120OtherMIBCBSM DME

Other names 1

  • Michigan Institute of Urology Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031125000770 MI Part B Supplier - Clinic/Group Practice 1052223492 Receives reassigned benefits from 96 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Novi, MI; Pontiac, MI; Rochester, MI; Rochester Hills, MI; Saint Clair Shores, MI; Southfield, MI; Troy, MI; Utica, MI…
O20050329001170 MI Part B Supplier - Clinic/Group Practice 1052223492 Receives reassigned benefits from 21 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Bloomfield, MI; Utica, MI; Troy, MI; Saint Clair Shores, MI; Rochester Hills, MI; Pontiac, MI; Macomb, MI; Livonia, MI…
O20100930066728 MI DME Supplier - Physician - Urology 1052223492 Practice locations: Troy, MI

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Wayne Macomb Urolog

Locations

130 Town Center Dr
Ste 101
Troy, MI 48084
Phone (248) 740-0670

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1295817799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "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": "130 TOWN CENTER DRIVE",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841773",
            "telephone_number": "248-740-0670",
            "fax_number": "248-740-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PHYSICIAN SERVICES OF MICHIGAN, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIANCE PHYSICIAN SERVICES OF MICHIGAN, P.C.",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "MCAULEY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "586-771-4820"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "340E062730",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB9133",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM DME",
            "identifier": "540E016120",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Michigan Institute of Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 3, 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.