NPIMap

Individual provider Active NPI

Sander J Paul, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Berkley, MI
National Provider Identifier
1447331764
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301052101 Issued in MI
Practice address
1949 W 12 Mile Rd
Ste 200
Berkley, MI 48072-1868
Phone
(248) 543-3700
Fax
(248) 543-4180
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301052101 MI Primary

Addresses

Primary practice location

1949 W 12 Mile Rd
Ste 200
Berkley, MI 48072-1868

Mailing address

1949 W 12 Mile Rd
Ste 200
Berkley, MI 48072-1868
Phone (248) 543-3700

Other identifiers 1

IdentifierTypeStateIssuer
2696353MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050128000726 MI Practitioner - Endocrinology 5890690820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Michigan Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Endocrine Consultants PCGroup PAC ID 2466357496, 6 clinicians

Practice addresses (Care Compare)

31500 Telegraph Rd
Suite 100
Bingham Farms, MI 48025-4368
Phone (248) 543-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
31.44 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
74.92

National Provider Directory

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

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1447331764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 W 12 MILE RD",
            "address_2": "STE 200",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721868",
            "telephone_number": "248-543-3700",
            "fax_number": "248-543-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 W 12 MILE RD",
            "address_2": "STE 200",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721868",
            "telephone_number": "248-543-3700",
            "fax_number": "248-543-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "SANDER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301052101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2696353",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.