Organization Active NPI

Sterling Family Medicine PC

  • Family Medicine Physician
  • Warren, MI
National Provider Identifier
1326381393
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301083381 Issued in MI
Legal business name
STERLING FAMILY MEDICINE PC
Practice address
2539 E 12 Mile Rd
Warren, MI 48092-5648
Phone
(586) 558-5075
NPI assigned
Mar 28, 2013
Last updated
Mar 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Authorized official

Name
Dr. Oleh J Bolukh, M.D.NPI 1598941148
Title
President
Phone
(586) 558-5075

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
Family Medicine Physician 207Q00000X 4301083381 MI Primary

Addresses

Primary practice location

2539 E 12 Mile Rd
Warren, MI 48092-5648

Mailing address

2539 E 12 Mile Rd
Warren, MI 48092-5648
Phone (586) 558-5075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130627000210 MI Part B Supplier - Clinic/Group Practice 7911146782 Receives reassigned benefits from 1 practitioner
Practice locations: Warren, 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
23D2058097Sterling Family Medicine PC2539 E 12 Mile Road, Warren, MI 48092Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory

Locations

2539 E 12 Mile Rd
Warren, MI 48092
Phone (586) 558-2981

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1326381393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925648",
            "telephone_number": "586-558-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925648",
            "telephone_number": "586-558-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STERLING FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "BOLUKH",
        "authorized_official_first_name": "OLEH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-558-5075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301083381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.