Active NPI
Seid Cosovic, MD
- Sports Medicine (Family Medicine) Physician
- Troy, MI
National Provider Identifier
1386703403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- SC057395
- Practice address
- 888 W Big Beaver Rd
Suite 309
Troy, MI 48084-4736 - Phone
- (248) 244-8700
- Fax
- (248) 244-8747
- NPI assigned
- Dec 6, 2006
- Last updated
- Jan 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | SC057395 | MI | Primary |
| Pain Medicine Physician | 208VP0000X | SC057395 | MI |
Addresses
Primary practice location
888 W Big Beaver Rd
Suite 309
Troy, MI 48084-4736
Mailing address
PO Box 99160
Troy, MI 48099-9160
Phone (248) 244-8700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0806335011 | Other | MI | BCBS |
| 3510124 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC057395 | MI | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Somerset Pain Clinic PC | Sports Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232409600000",
"number": "1386703403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 99160",
"city": "TROY",
"state": "MI",
"postal_code": "480999160",
"telephone_number": "248-244-8700",
"fax_number": "248-244-8747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 W BIG BEAVER RD",
"address_2": "SUITE 309",
"city": "TROY",
"state": "MI",
"postal_code": "480844736",
"telephone_number": "248-244-8700",
"fax_number": "248-244-8747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSOVIC",
"first_name": "SEID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2009-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "MI",
"license": "SC057395",
"primary": true
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "MI",
"license": "SC057395",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0806335011",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3510124",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.