Individual provider Active NPI

Edi Levi, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
National Provider Identifier
1336159649
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301079179 Issued in MI
Practice address
4646 John R St
Palms 11Lab
Detroit, MI 48201-1916
Phone
(313) 576-1000
Fax
(313) 576-1120
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301079179 MI Primary

Addresses

Primary practice location

4646 John R St
Palms 11Lab
Detroit, MI 48201-1916

Mailing address

4646 John R St
Palms 11Lab
Detroit, MI 48201-1916

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
I20260113001201 MI Practitioner - Pathology 5799261491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Diagnostic Pathologists PLLCGroup PAC ID 9739253279, 8 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-5401

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301079179MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Diagnostic Pathologists, PLLC Hematology CurrentSince Dec 9, 2025 Accepting new patients

Locations

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 1

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 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1336159649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "address_2": "PALMS 11LAB",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "address_2": "PALMS 11LAB",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-1000",
            "fax_number": "313-576-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVI",
        "first_name": "EDI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301079179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.