NPIMap

Organization Active NPI

Regents of the University of Michigan

  • Dermatology Physician
  • Ann Arbor, MI
National Provider Identifier
1528097128
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
David Christopher Miller
Title
President
Phone
(734) 936-3568

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NI0002X
Pediatric Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NP0225X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Provider Enrollment
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other identifiers 1

IdentifierTypeStateIssuer
070H176100OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000325 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 2,340 practitioners
This NPI is an additional NPI on the enrollment
O20031117000318 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 30 practitioners
Practice locations: Ann Arbor, MI; Dexter, MI; Northville, MI

National Provider Directory

National Provider Directory
Tax ID family
Regents of Univ of Michigan157 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 17

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

FacilityTypeRoleSince
University of Michigan Health-Sparrow EatonCharlotte, MI, CCN 231327 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health - WestWyoming, MI, CCN 230236 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 15, 2016
University of Michigan Health-Sparrow LansingLansing, MI, CCN 230230 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow IoniaIonia, MI, CCN 231331 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-SparrowLansing, MI, CCN 23T230 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2024
University of Michigan Health-SparrowCarson City, MI, CCN 230208 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
Chelsea HospitalChelsea, MI, CCN 230259 Hospital 5% Or Greater Direct Ownership Interest (49%) Jul 1, 2018
Chelsea HospitalChelsea, MI, CCN 23T259 Hospital 5% Or Greater Direct Ownership Interest (49%) Jul 1, 2018
University of Michigan Health-SparrowSaint Johns, MI, CCN 23Z326 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow CarsonCarson City, MI, CCN 23U208 Hospital 5% Or Greater Indirect Ownership Interest (100%) Mar 1, 2025
University of Michigan Health-SparrowLansing, MI, CCN 231519 Hospice 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow IoniaIonia, MI, CCN 238550 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-SparrowGreenville, MI, CCN 233996 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow Ithaca Primary CareIthaca, MI, CCN 238517 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-SparrowStanton, MI, CCN 238574 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow Portland Primary CarePortland, MI, CCN 238631 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow Saranac Primary CareSaranac, MI, CCN 238698 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1528097128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-936-3568"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "070H176100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.