NPIMap

Organization Active NPI

McLaren Macomb

  • Internal Medicine Physician
  • Mount Clemens, MI
National Provider Identifier
1396014601
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MCLAREN MACOMB
Practice address
1000 Harrington Blvd.
Mount Clemens, MI 48043
Phone
(586) 493-8000
NPI assigned
Dec 16, 2011
Last updated
May 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Authorized official

Name
Mr. Thomas M Brisse
Title
Ceo
Phone
(586) 493-8083

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X

Addresses

Primary practice location

1000 Harrington Blvd.
Mount Clemens, MI 48043

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120001000 MI Part B Supplier - Clinic/Group Practice 8921912791 Receives reassigned benefits from 190 practitioners
1 other NPI on this enrollment
Practice locations: Macomb, MI; Mount Clemens, MI; New Baltimore, MI; Pontiac, MI; Roseville, MI; Saint Clair, MI; Shelby Township, MI; Sterling Heights, MI…

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations (25 of 38)

32901 23 Mile Rd
Ste 120
Chesterfield, MI 48047
Phone (586) 725-4604

5680 Bow Pointe Dr
Ste 101
Clarkston, MI 48346
Phone (248) 922-6610

21550 Harrington St
Ste 100
Clinton Township, MI 48036
Phone (586) 783-9581

21550 Harrington St
Ste 200
Clinton Township, MI 48036
Phone (586) 466-4810

22500 Metropolitan Pkwy
#201
Clinton Township, MI 48035
Phone (586) 493-3732

37055 S Gratiot Ave
Clinton Township, MI 48036
Phone (586) 783-9581

21510 Harrington St
Ste 200
Clinton Twp, MI 48036
Phone (586) 493-3297

21510 Harrington St
Ste 202
Clinton Twp, MI 48036
Phone (586) 791-5250

21510 Harrington St
Ste 203
Clinton Twp, MI 48036
Phone (586) 233-5544

22500 Metropolitan Pkwy
Ste 201
Clinton Twp, MI 48035
Phone (586) 493-3732

36500 S Gratiot Ave
Ste 101
Clinton Twp, MI 48035
Phone (586) 493-3723

36500 S Gratiot Ave
Ste 102
Clinton Twp, MI 48035
Phone (586) 790-9003

36535 Harper Ave
Clinton Twp, MI 48035
Phone (586) 792-8877

36539 Harper Ave
Clinton Twp, MI 48035
Phone (586) 792-8877

36549 Harper Ave
Clinton Twp, MI 48035
Phone (810) 791-3150

37244 S Groesbeck Hwy
Clinton Twp, MI 48036
Phone (810) 469-2930

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

38864 Hilldale St
Clinton Twp, MI 48036
Phone (586) 233-5554

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

36267 26 Mile Rd
Ste 5
Lenox, MI 48048
Phone (586) 591-1420

66440 Gratiot Ave
Lenox, MI 48050
Phone (586) 430-4022

66440 Gratiot Ave
Ste 102
Lenox, MI 48050
Phone (586) 430-4020

16700 21 Mile Rd
Ste 101
Macomb, MI 48044
Phone (586) 226-5702

16700 21 Mile Rd
Ste 106
Macomb, MI 48044
Phone (586) 566-5949

46401 Romeo Plank Rd
Ste 4
Macomb, MI 48044
Phone (586) 226-8000

Practitioners & affiliated clinicians

Practitioners 209

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.

View all 209

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1396014601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-1000",
            "fax_number": "810-342-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON BLVD.",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN MACOMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "BRISSE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "586-493-8083",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.