Individual provider Active NPI

Vicente Redondo, MD

  • Infectious Disease Physician
  • Sterling Heights, MI
National Provider Identifier
1598865602
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301048942 Issued in MI
Practice address
43134 Dequindre Rd
Sterling Heights, MI 48314-1723
Phone
(586) 446-8688
Fax
(586) 446-9994
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301048942 MI
Infectious Disease Physician 207RI0200X 4301048942 MI Primary

Addresses

Primary practice location

43134 Dequindre Rd
Sterling Heights, MI 48314-1723

Mailing address

46661 Fields Dr
Shelby TWP, MI 48315-5135
Phone (586) 932-6331

Other practice location 1

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 932-6331

Other identifiers 4

IdentifierTypeStateIssuer
1105026191OtherMIBCBSMI PERSONAL PIN
VR048942OtherMILICENSE PIN
2878632MedicaidMI
4749062MedicaidMI

Other names 1

  • Vicente Redondo-Lopez Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060228000123 MI Practitioner - Infectious DiseasePractitioner - Internal Medicine 4880600907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (888) 220-6432

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (888) 220-6432

1231 Pine Grove Ave
Suite 1B
Port Huron, MI 48060-3500
Phone (810) 996-1993

15474 N Haggerty Rd
Plymouth, MI 48170-4893
Phone (734) 335-6103

19991 Hall Rd
Suite 105
Macomb, MI 48044-4254
Phone (888) 220-6432

43134 Dequindre Rd
Sterling Heights, MI 48314-1723
Phone (586) 446-8688

4805 Towne Centre Rd
Suite 103
Saginaw, MI 48604-2831
Phone (877) 448-3627

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301048942MIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC Infectious Disease CurrentSince Oct 1, 2014 Accepting new patients
Schoenherr Medical Assoicates PC Internal Medicine Current Accepting new patients
Metro Infectious Disease Consultants LLC Infectious Disease CurrentSince Oct 1, 2014 Accepting new patients
Metro Infectious Disease Consultants, LLC Infectious Disease Past Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

19991 Hall Rd
Ste 105
Macomb, MI 48044
Phone (586) 247-8609

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

15474 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 335-6103

14510 Northline Rd
Southgate, MI 48195
Phone (734) 282-2800

5280 Metropolitan Pkwy
Sterling Heights, MI 48310
Phone (586) 446-8688

43134 Dequindre Rd
Sterling Hts, MI 48314
Phone (586) 446-8688

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

27101 Schoenherr Rd
Ste 100
Warren, MI 48088
Phone (586) 298-6796

27101 Schoenherr Rd
Warren, MI 48088
Phone (586) 573-6669

Interoperability endpoints

  • Direct secure messaging: vredondo1148784@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1598865602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46661 FIELDS DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483155135",
            "telephone_number": "586-932-6331",
            "fax_number": "586-932-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43134 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141723",
            "telephone_number": "586-446-8688",
            "fax_number": "586-446-9994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11800 E 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933472",
            "country_code": "US",
            "telephone_number": "586-932-6331",
            "fax_number": "586-932-6366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDONDO",
        "first_name": "VICENTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301048942",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301048942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI PERSONAL PIN",
            "identifier": "1105026191",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE PIN",
            "identifier": "VR048942",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2878632",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4749062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICENTE",
            "last_name": "REDONDO-LOPEZ",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.