Organization Active NPI

North Oakland ASC, LLC

  • Gastroenterology Physician
  • Waterford, MI
National Provider Identifier
1508167107
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NORTH OAKLAND ASC, LLC
Practice address
1305 N Oakland Blvd
Waterford, MI 48327-1547
Phone
(248) 666-5552
NPI assigned
Nov 12, 2010
Organization subpart
Yes
Parent organization
OAKLAND PHYSICIANS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Authorized official

Name
Mr. Michael Derubeis, CFO
Title
Cfo
Phone
(248) 857-7583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X MI Primary

Addresses

Primary practice location

1305 N Oakland Blvd
Waterford, MI 48327-1547

Mailing address

461 W Huron St
Suite 206
Pontiac, MI 48341-1601
Phone (248) 857-7583

National Provider Directory

National Provider Directory
Part of
Oakland Physician Med LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8315 Reliable Pkwy
Chicago, IL 60685

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": "1289520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289520000000",
    "number": "1508167107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "address_2": "SUITE 206",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-857-7583",
            "fax_number": "248-857-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271547",
            "telephone_number": "248-666-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH OAKLAND ASC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLAND PHYSICIANS MEDICAL CENTER",
        "enumeration_date": "2010-11-12",
        "last_updated": "2010-11-12",
        "status": "A",
        "authorized_official_last_name": "DERUBEIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "248-857-7583",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.