Individual provider Active NPI

Nicole Renee Seleno, M.D.

  • Emergency Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1326272238
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
51799 Issued in CO
Practice address
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3000
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 51799 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Mailing address

3060 Newcastle Rd
Ann Arbor, MI 48104-4148
Phone (970) 420-3966

Other identifiers 2

IdentifierTypeStateIssuer
023255OtherCOKAISER COMMERCIAL NUMBER
14520851MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nseleno23981@direct.trinity-health.org

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
I20131003000453 MI Practitioner - Emergency Medicine 2860646411 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epmg of Michigan PCGroup PAC ID 4789596339, 108 clinicians

Practice addresses (Care Compare)

7575 Grand River Rd
Brighton, MI 48114-9309
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51799COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epmg of Michigan, P.C. Emergency Medicine CurrentSince Aug 1, 2013 Accepting new patients
Sjmhs Anesthesia Services Current Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Apr 17, 2017 Accepting new patients
Saint Joseph Mercy Livingston Hospital Emergency Medicine CurrentSince Apr 17, 2017 Accepting new patients
Chelsea Community Hospital CurrentSince Feb 8, 2020 Accepting new patients
Chelsea Community Hospital CurrentSince Feb 8, 2020 Accepting new patients

Locations

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1326272238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 NEWCASTLE RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044148",
            "telephone_number": "970-420-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELENO",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "51799",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "023255",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14520851",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nseleno23981@direct.trinity-health.org",
            "affiliation": "N",
            "address_1": "5301 McAuley Dr",
            "city": "Ypsilanti",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481971051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.