Patrick Anselm Charles, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301058495 Issued in MI

Practice address

18601 Mack Ave
Suite 2
Detroit, MI 48236-3250

Phone

(313) 640-1250

Fax

(313) 640-1291

NPI assigned

Jul 7, 2005

Last updated

Dec 18, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Internal Medicine

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vpotla@direct.lumeris.com

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.

• Patrick a. Charles MD PC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1205878824
  Medicare reassignment NPD Authorized official
• Cottab Medical Group, PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1164529442
  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Royal Oak

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Grosse Pointe

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1396742151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21158",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482210158",
            "telephone_number": "313-640-1250",
            "fax_number": "313-640-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18601 MACK AVE",
            "address_2": "SUITE 2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482363250",
            "telephone_number": "313-640-1250",
            "fax_number": "313-640-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "PATRICK",
        "middle_name": "ANSELM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301058495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PROVIDER #",
            "identifier": "1108233132",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2876665",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles M Johnson Podiatrist PC
• Alix Charles Jr., MD
• Fred Henry Daniel Charles, MD
• Jasmine Charles, M.S.W
• Nicole Diane Charles
• Juanita Charleston
• Camillia Lashawn Charley, LBSW
• Charli's Angels Home Healthcare Company
• Charlies Abundant Home Health Care Agency LLC
• Dimple Charls

• Internal Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.