Individual provider Active NPI

Felicia Ivascu

  • Surgical Critical Care Physician
  • Royal Oak, MI
National Provider Identifier
1316078470
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
FI076031 Issued in MI
Practice address
3535 W 13 Mile Rd
607
Royal Oak, MI 48073
Phone
(248) 288-1130
Fax
(248) 288-5931
NPI assigned
Mar 8, 2007
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X FI076031 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
607
Royal Oak, MI 48073

Mailing address

3535 W 13 Mile Rd
607
Royal Oak, MI 48073
Phone (248) 288-1130

Other identifiers 1

IdentifierTypeStateIssuer
061807327OtherMITAX IDENTIFICATION

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
I20070607000034 MI Practitioner - General SurgeryPractitioner - Peripheral Vascular DiseasePractitioner - Vascular Surgery 4183722689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Peripheral Vascular Disease, Vascular Surgery
Education
Wayne State University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

3577 W 13 Mile Rd
Royal Oak, MI 48073-6710

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-0575

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FI076031MIMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Jun 5, 2017 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Sep 16, 2022 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Jun 5, 2017 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010

3535 W 13 Mile Rd
#607
Royal Oak, MI 48073
Phone (248) 288-1130

3535 W 13 Mile Rd
Ste 501
Royal Oak, MI 48073
Phone (248) 288-1130

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: fivascu1457403@epic00.shdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1316078470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "607",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-288-1130",
            "fax_number": "248-288-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "607",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-288-1130",
            "fax_number": "248-288-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVASCU",
        "first_name": "FELICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "FI076031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "061807327",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.