Active NPI
St Maries
- Internal Medicine Physician
- Southfield, MI
National Provider Identifier
1508670753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ST MARIES
- Practice address
- 24555 Southfield Rd Ste 100
Southfield, MI 48075-2788 - Phone
- (248) 809-3795
- NPI assigned
- Feb 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melvie Tora Berkery
- Title
- Owner
- Phone
- (248) 809-3795
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
24555 Southfield Rd Ste 100
Southfield, MI 48075-2788
Mailing address
24555 Southfield Rd Ste 100
Southfield, MI 48075-2788
Phone (248) 809-3795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250318001985 | MI | Part B Supplier - Clinic/Group Practice | 5294984837 |
Receives reassigned benefits from 1 practitioner Practice locations: Southfield, MI |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- St Marie'S
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Southfield, MI
- NPI 1548528656
Locations
29501 Greenfield Rd
Ste 216
Southfield, MI 48076
Phone (248) 808-6064
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1639453228
Internal Medicine, MI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738800000000",
"number": "1508670753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24555 SOUTHFIELD RD STE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752788",
"telephone_number": "248-809-3795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24555 SOUTHFIELD RD STE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752788",
"telephone_number": "248-809-3795"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST MARIES",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-06",
"last_updated": "2025-02-06",
"certification_date": "2025-02-06",
"status": "A",
"authorized_official_last_name": "BERKERY",
"authorized_official_first_name": "MELVIE",
"authorized_official_middle_name": "TORA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "248-809-3795"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.