NPIMap

University Neurosurgical Associates, PC

Organization Active NPI Neurological Surgery Physician · Ypsilanti, MI

NPI 1508220864 · NPPES record last updated Mar 5, 2025

Key facts

NPI
1508220864
Entity type
Organization (NPI type 2)
Primary specialty
Neurological Surgery Physician 207T00000X
Legal business name
UNIVERSITY NEUROSURGICAL ASSOCIATES, PC
Practice address
135 S Prospect St
Ypsilanti, MI 48198-7914
Phone
(248) 784-3667
Fax
(248) 869-3982
NPI assigned
Apr 12, 2016
Organization subpart
No

Authorized official

Name
Robert R Johnson, MD
Title
President
Phone
(248) 784-3667

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

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

  • Olga Klahm, PA-C Physician Assistant · Royal Oak, MI · NPI 1033441548
    NPD
  • Pradeep Setty, D.O. Neurological Surgery Physician · Trenton, MI · NPI 1467877860
    NPD NEUROLOGICAL SURGERY

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050127000624 MI Part B Supplier - Clinic/Group Practice 9739139759 Receives reassigned benefits from 74 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southfield, MI; Ypsilanti, MI; Waterford, MI; Walled Lake, MI; Troy, MI; Trenton, MI; Royal Oak, MI; Pontiac, MI…

National Provider Directory

Tax ID family
University Neurosurgical Associates (15 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207T00000X Yes

Addresses

Primary practice location

135 S Prospect St
Ypsilanti, MI 48198-7914

Mailing address

25500 Meadowbrook Rd Ste 150
Novi, MI 48375-1880
Phone (248) 784-3667

Other names

  • Michigan Head and Spine Institute Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 5, 2025.

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1508220864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751880",
            "telephone_number": "248-784-3667",
            "fax_number": "248-869-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S PROSPECT ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987914",
            "telephone_number": "248-784-3667",
            "fax_number": "248-869-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY NEUROSURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-784-3667",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Head and Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

All providers in Ypsilanti, MI · Neurological Surgery Physician in Michigan

Sources for this page

Verify at the official NPI Registry.