Organization Active NPI

Select Surgical PLLC

  • Surgery Physician
  • Mount Clemens, MI
National Provider Identifier
1457591174
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101008358 Issued in MI
Legal business name
SELECT SURGICAL PLLC
Practice address
1030 Harrington St
103
Mount Clemens, MI 48043-2967
Phone
(586) 466-6230
Fax
(586) 493-3828
NPI assigned
Feb 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Stephen D Cahill, D.O.NPI 1295725620
Title
President
Phone
(586) 466-6230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 5101008358 MI Primary

Addresses

Primary practice location

1030 Harrington St
103
Mount Clemens, MI 48043-2967

Mailing address

1030 Harrington St
103
Mount Clemens, MI 48043-2967
Phone (586) 466-6230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090319000658 MI Part B Supplier - Clinic/Group Practice 7517024409 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton Township, MI; Mount Clemens, MI

National Provider Directory

National Provider Directory

Locations

1030 Harrington St
Ste 1
Mount Clemens, MI 48043
Phone (586) 466-6230

1030 Harrington St
Ste 103
Mount Clemens, MI 48043
Phone (586) 466-6230

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1457591174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST",
            "address_2": "103",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-466-6230",
            "fax_number": "586-493-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST",
            "address_2": "103",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-466-6230",
            "fax_number": "586-493-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SURGICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-21",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "CAHILL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-466-6230",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101008358",
            "primary": true
        }
    ],
    "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 Apr 20, 2016; 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.