The Porretta Center for Orthopaedic Surgery, PLLC
Organization Active NPI Orthopaedic Surgery Physician · Novi, MI
NPI 1306818331 · NPPES record last updated Dec 14, 2023
Key facts
- NPI
- 1306818331
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- THE PORRETTA CENTER FOR ORTHOPAEDIC SURGERY, PLLC
- Practice address
- 26750 Providence Pkwy Ste 200
Novi, MI 48374-1212 - Phone
- (866) 974-2673
- Fax
- (866) 939-2673
- NPI assigned
- Feb 3, 2006
- Organization subpart
- No
Authorized official
- Name
- David Markel III, MD
- Title
- Managing Partner
- Phone
- (866) 974-2673
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 2
Practitioners 55
-
Billal Bandar, DPT
-
Kimberly Bell Darke, DPT
-
Leila Ettefagh, M.D.
-
Jessica L Gelfand, PA-C
-
Majdi M Ibrahim, PT
-
William K. Kesto, MD
-
Danielle Marie Meyka, DPM
-
Eric Austin Neal, DPT
-
Muslimah Rashed, PT
-
Kellie Kristine Savage, PA-C
-
Timothy Philip Scott, PA-C
-
Shad Siddiqi, DO
-
Ashley Lynne Tamme, PA-C
-
David C Markel, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070911000839 | MI | Part B Supplier - Clinic/Group Practice | 2860585544 |
Receives reassigned benefits from 53 practitioners Practice locations: Novi, MI; Southfield, MI; Plymouth, MI; Howell, MI; Livonia, MI; Dexter, MI; Grand Blanc, MI; Brighton, MI |
| O20100930030819 | MI | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 2860585544 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Southfield, MI |
National Provider Directory
Locations
26750 Providence Pkwy
#240
Novi, MI 48374
Phone (248) 349-7843
26750 Providence Pkwy
Ste 240
Novi, MI 48374
Phone (248) 687-7440
22250 Providence Dr
Ste 40
Southfield, MI 48075
Phone (248) 563-0306
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | MI | Yes | |
| Pediatric Orthopaedic Surgery Physician |
207XP3100X | MI | ||
| Adult Reconstructive Orthopaedic Surgery Physician |
207XS0114X | MI | ||
| Orthopaedic Surgery of the Spine Physician |
207XS0117X | MI | ||
| Sports Medicine (Orthopaedic Surgery) Physician |
207XX0005X | MI | ||
| Orthopaedic Trauma Physician |
207XX0801X | MI | ||
| Podiatrist |
213E00000X | MI | ||
| Foot & Ankle Surgery Podiatrist |
213ES0103X | MI | ||
| Physical Therapist |
225100000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | MI | ||
| Physician Assistant |
363A00000X | MI | ||
| Surgical Physician Assistant |
363AS0400X | MI |
Addresses
Primary practice location
26750 Providence Pkwy Ste 200
Novi, MI 48374-1212
Mailing address
18444 N 25TH Ave
Ste 310
Phoenix, AZ 85023-1261
Phone (866) 974-2673
Other practice location 1
22250 Providence Dr Ste 401
Southfield, MI 48075-6212
Phone (866) 974-2683
Other practice location 2
14800 Farmington Rd Ste 103
Livonia, MI 48154-5464
Phone (866) 974-2673
Other practice location 3
26750 Providence Pkwy Ste 240
Novi, MI 48374-1211
Phone (866) 974-2673
Other practice location 4
22250 Providence Dr Ste 405
Southfield, MI 48075-6212
Phone (866) 974-2673
Other practice location 5
8273 Grand River Rd Ste 210
Brighton, MI 48114-9346
Phone (866) 974-3673
Other practice location 6
8273 Grand River Rd Ste 210
Brighton, MI 48114-9346
Phone (866) 974-2673
Other names
- The CORE Institute
Other providers in Novi, MI
- Thai Spa Pavilion 3 LLC
- Jeanette Thai
- McKenzie A Thayer
- The Allergy Suite
- The Porretta Center for Orthopaedic Surgery, PLLC
- The Shower Lady LLC
- Matthew Theisen
- Brittany Lynn Thelen
- Daniel Theo-Gonzalez
- Melody Theodore
All providers in Novi, MI · Orthopaedic Surgery Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.