Organization Active NPI

Michigan Neurosurgical Specialists PC

  • Clinic/Center
  • Waterford, MI
National Provider Identifier
1295871770
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MICHIGAN NEUROSURGICAL SPECIALISTS PC
Practice address
5220 Highland Rd
Suite 210
Waterford, MI 48327-1913
Phone
(248) 383-1030
Fax
(248) 383-1031
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Authorized official

Name
Steven M Rapp, MDNPI 1073589446
Title
Owner
Phone
(248) 383-1030

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5220 Highland Rd
Suite 210
Waterford, MI 48327-1913

Mailing address

5220 Highland Rd
Suite 210
Waterford, MI 48327-1913
Phone (248) 383-1030

Other identifiers 1

IdentifierTypeStateIssuer
140F319840OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051229000309 MI Part B Supplier - Clinic/Group Practice 2163444571 Receives reassigned benefits from 9 practitioners
Practice locations: Waterford, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2268825Michigan Neurosurgical Specialists5220 Highland Road Suite 210, Waterford, MI 48327Certificate of waiverSep 18, 2026

National Provider Directory

National Provider Directory

Locations

4000 Highland Rd
Ste 102
Waterford, MI 48328
Phone (248) 738-9166

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1295871770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD",
            "address_2": "SUITE 210",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271913",
            "telephone_number": "248-383-1030",
            "fax_number": "248-383-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD",
            "address_2": "SUITE 210",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271913",
            "telephone_number": "248-383-1030",
            "fax_number": "248-383-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN NEUROSURGICAL SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "RAPP",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-383-1030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "140F319840",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.