Organization Active NPI

Southeast Michigan Rehab & Pain PLLC

  • Physical Medicine & Rehabilitation Physician
  • Ann Arbor, MI
National Provider Identifier
1417420886
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SOUTHEAST MICHIGAN REHAB & PAIN PLLC
Practice address
1070 Rosewood St
Ann Arbor, MI 48104-6250
Phone
(734) 462-0340
NPI assigned
Jan 8, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Dr. Anothony Meram, DO
Title
President
Phone
(248) 722-0108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1070 Rosewood St
Ann Arbor, MI 48104-6250

Mailing address

890 Wolverine Dr
Wolverine Lake, MI 48390-2377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190121000377 MI Part B Supplier - Clinic/Group Practice 0941547558 Receives reassigned benefits from 1 practitioner
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

1070 Rosewood St
Ann Arbor, MI 48104
Phone (248) 722-0108

39595 W 10 Mile Rd
Ste 103
Novi, MI 48375
Phone (248) 722-0108

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1417420886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 WOLVERINE DR",
            "city": "WOLVERINE LAKE",
            "state": "MI",
            "postal_code": "483902377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 ROSEWOOD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046250",
            "telephone_number": "734-462-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MICHIGAN REHAB & PAIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "MERAM",
        "authorized_official_first_name": "ANOTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-722-0108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.