Michigan Spine and Brain Surgeons, PLLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

MICHIGAN SPINE AND BRAIN SURGEONS, PLLC

Practice address

22250 Providence Dr
Suite 601
Southfield, MI 48075-4825

Phone

(248) 569-7745

Fax

(248) 569-4539

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Teck Mun Soo, M.D.NPI 1225020555

Title

President

Phone

(248) 569-7745

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JBEFBA

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teck Mun Soo, MD

  • Neurological Surgery Physician
  • Southfield, MI
  • NPI 1225020555
  Medicare reassignment Authorized official
• Daniel Augusten Carr, D.O.

  • Neurological Surgery Physician
  • Southfield, MI
  • NPI 1114285707
  Medicare reassignment NPD
• Chad Claus, D.O.

  • Neurological Surgery Physician
  • Southfield, MI
  • NPI 1134579451
  Medicare reassignment NPD
• Prashant Sudhir Kelkar, D.O.

  • Neurological Surgery Physician
  • Southfield, MI
  • NPI 1053536755
  Medicare reassignment NPD
• Boyd Richards, DO

  • Neurological Surgery Physician
  • Southfield, MI
  • NPI 1952438269
  Medicare reassignment NPD
• Peter Louis Bono, DO

  • Orthopaedic Surgery of the Spine Physician
  • Southfield, MI
  • NPI 1346234770
  Medicare reassignment
• Clifford Michael Houseman, D.O.

  • Neurological Surgery Physician
  • Southfield, MI
  • NPI 1093938482
  Medicare reassignment

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1336130863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPINE AND BRAIN SURGEONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "SOO",
        "authorized_official_first_name": "TECK",
        "authorized_official_middle_name": "MUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-569-7745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0F32853",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Physical Therapy & Rehab Center, Inc.
• Michigan Physical Therapy Services LLC
• Michigan Premier Geriatrics PLLC
• Michigan Rehabilitation & Physical Therapy LLC
• Michigan Resource Services
• Michigan Spine and Sports Management P.C.
• Michigan Therapeutic Solutions Inc
• Michigan TMJ Headache Institute
• Michigan United Cerebral Palsy
• Michigan Urological Institute

• Neurological Surgery Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Neurological Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.