Individual provider Active NPI

Michael C Willoughby, D.O.

  • Cardiovascular Disease Physician
  • Mount Clemens, MI
National Provider Identifier
1457589582
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036137782 Issued in IL
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 493-8000
NPI assigned
Jun 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101018254 MI
Clinical Cardiac Electrophysiology Physician 207RC0001X 5101018254 MI
Cardiovascular Disease Physician 207RC0000X 036137782 IL Primary

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

1000 Harrington St
Mount Clemens, MI 48043-2920

Other practice location 1

12251 S 80th Ave Ste 1520
Palos Heights, IL 60463-1290
Phone (708) 923-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131021001859 MI Practitioner - Cardiac Electrophysiology 8123253598 Reassigns benefits to 3 organizations
I20160128000948 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8123253598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Michigan State University College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12251 S 80TH Ave
Suite 1520
Palos Heights, IL 60463-1290
Phone (708) 923-4200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Macomb Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
McLaren Medical Group Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 22, 2025 Accepting new patients
McLaren Oakland Internal Medicine Current Accepting new patients
Cardiology Associates of Michigan, P.C. Cardiovascular Disease CurrentSince Mar 1, 2019 Accepting new patients
McLaren Medical Group CurrentSince Mar 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 22, 2025 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

12251 S 80th Ave
Ste 1520
Palos Heights, IL 60463
Phone (708) 923-3936

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

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

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

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

25910 Kelly Rd
Ste B
Roseville, MI 48066
Phone (586) 772-3366

50505 Schoenherr Rd
Ste 320
Shelby Township, MI 48315
Phone (586) 580-3062

5210 Highland Rd
Ste 200
Waterford, MI 48327
Phone (248) 625-9099

Interoperability endpoints

  • Direct secure messaging: cameron.willoughby.p1@direct.cardofmich.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mwilloughby533673@direct.hfhs.org

Organizations & group practices 8

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1246060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1457589582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12251 S 80th Ave Ste 1520",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604631290",
            "country_code": "US",
            "telephone_number": "708-923-4200",
            "fax_number": "708-923-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-27",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101018254",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MI",
            "license": "5101018254",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036137782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.