NPIMap

Organization Active NPI

Professional Emergency Care, PC

  • Emergency Medicine Physician
  • Clinton Township, MI
National Provider Identifier
1326235698
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PROFESSIONAL EMERGENCY CARE, PC
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2601
Fax
(888) 861-8740
NPI assigned
Oct 1, 2007
Last updated
Jul 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Authorized official

Name
John Bauer, MDNPI 1346258233
Title
Cmo
Phone
(734) 632-0175

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

38935 Ann Arbor Rd
Livonia, MI 48150-3397
Phone (734) 632-0175

Other identifiers 3

IdentifierTypeStateIssuer
700E014610OtherMIBCBS
DB9172OtherMIRAILROAD MEDICARE
1326235698MedicaidMI

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040119000662 MI Part B Supplier - Clinic/Group Practice 3870493588 Receives reassigned benefits from 47 practitioners
3 other NPIs on this enrollment
Practice locations: Clinton Township, MI; Coldwater, MI
O20040504001470 MI Part B Supplier - Clinic/Group Practice 3870493588 Receives reassigned benefits from 16 practitioners
Practice locations: Clinton Township, MI; Coldwater, MI
O20040504001497 MI Part B Supplier - Clinic/Group Practice 3870493588 Receives reassigned benefits from 16 practitioners
Practice locations: Clinton Township, MI; Coldwater, MI

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 81

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1326235698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-632-0175",
            "fax_number": "888-861-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2601",
            "fax_number": "888-861-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EMERGENCY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "734-632-0175",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700E014610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB9172",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326235698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.