Timothy David Logan, D.O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

5101015334 Issued in MI

Practice address

1000 Harrington St
Mount Clemens, MI 48043-2920

Phone

(586) 493-8000

NPI assigned

May 23, 2007

Last updated

Sep 2, 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

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

Cardiovascular Disease (Cardiology)Also: Interventional Cardiology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren MacombGroup PAC ID 8921912791, 131 clinicians

McLaren OaklandGroup PAC ID 0547173213, 51 clinicians

McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
• McLaren Oakland Hospital, Pontiac, MI, CCN 230207
• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tlogan61662@direct.hfhs.org

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• McLaren Macomb

  • Rehabilitation Hospital Unit
  • Mount Clemens, MI
  • NPI 1033710116

  Corporate Director

  CMS ownership
• McLaren Macomb

  • Psychiatric Hospital Unit
  • Shelby Township, MI
  • NPI 1184206385

  Corporate Director

  CMS ownership
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327

  Corporate Director

  CMS ownership

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.

• McLaren Macomb

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1396014601

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066
  Medicare reassignment Care Compare group NPD
• McLaren Oakland

  • Family Medicine Physician
  • Pontiac, MI
  • NPI 1053463778

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD
• McLaren Oakland

  • Psychiatric Hospital Unit
  • Pontiac, MI
  • NPI 1245817881
  NPD
• McLaren Oakland

  dba POH Regional Medical Center

  • General Practice Physician
  • Pontiac, MI
  • NPI 1790055143
  NPD
• General Hosp Medical Assoc, P.C.

  • Cardiovascular Disease Physician
  • Mount Clemens, MI
  • NPI 1518000223
  NPD (past)
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327
  NPD (past)

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation
• McLaren Macomb

  • Psychiatric Hospital Unit
  • Shelby Township, MI
  • NPI 1184206385
  Care Compare affiliation
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327
  Care Compare affiliation
• McLaren Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1376564088
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Troy

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

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188691200000",
    "number": "1477763779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21608 ENGLEHARDT ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802928",
            "telephone_number": "586-218-4088"
        },
        {
            "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": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101015334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tysha Linnex
• Brian Michael Litch, DO
• Living Water Christian Counseling Center
• Cynthia Lockwood
• Joyce Michele Logan
• Kevin Paul Lokar, M.D.
• Gino Michael Lombardo, DO
• Melanie May Longworth-Beattie, PSY.D.
• Andrew Loosvelt
• Kathryn Loren, LMSW

• Cardiovascular Disease Physician in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.