NPIMap

Individual provider Active NPI

Tiberio Michele Frisoli, MD

  • Cardiovascular Disease Physician
  • Brownstown TWP, MI
National Provider Identifier
1609178581
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301100388 Issued in MI
Practice address
23050 West Rd Ste 120
Brownstown TWP, MI 48183-1470
Phone
(734) 671-1510
Fax
(734) 671-1570
NPI assigned
Nov 26, 2010
Last updated
May 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301100388 MI
Internal Medicine Physician 207R00000X 4301100388 MI
Hospitalist Physician 208M00000X 4301100388 MI
Cardiovascular Disease Physician 207RC0000X 4301100388 MI Primary

Addresses

Primary practice location

23050 West Rd Ste 120
Brownstown TWP, MI 48183-1470

Mailing address

2915 John R St
Apt 306
Detroit, MI 48201-2908
Phone (201) 618-3856

Other practice location 1

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131121001169 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Emergency MedicinePractitioner - Interventional Cardiology 8123254117 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, shared by 11 NPIs, 476 clinicians
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800

23050 W Rd
120 Henry Ford Wyandotte Cardiology Bro
Brownstown TWP, MI 48183-1470
Phone (734) 671-1510

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jan 1, 2018 Accepting new patients
Wa Foote Memorial Hospital Inc. Hospitalist CurrentSince Sep 12, 2018 Accepting new patients
W.a. Foote Memorial Hospital Cardiovascular Disease CurrentSince Aug 1, 2017 Accepting new patients
W.a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Wyandotte Hospital Cardiovascular Disease CurrentSince Jan 1, 2018 Accepting new patients
W. a. Foote Memorial Hospital Internal Medicine Current Accepting new patients
Independent Emergency Physicians, P.C. CurrentSince Mar 20, 2017 Accepting new patients
Henry Ford Health System CurrentSince Nov 10, 2018 Accepting new patients
Henry Ford Health System Cardiovascular Disease CurrentSince Nov 10, 2018 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-4316

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#363
Detroit, MI 48202
Phone (313) 916-2020

1100 E Michigan Ave
Ste 201
Jackson, MI 49201
Phone (517) 205-7605

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Interoperability endpoints

  • Direct secure messaging: tfrisoli61622@direct.hfhs.org

Organizations & group practices 11

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

Hospital & facility affiliations 7

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": "1290729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1609178581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 JOHN R ST",
            "address_2": "APT 306",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012908",
            "telephone_number": "201-618-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23050 WEST RD STE 120",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831470",
            "telephone_number": "734-671-1510",
            "fax_number": "734-671-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRISOLI",
        "first_name": "TIBERIO",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-26",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301100388",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301100388",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301100388",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301100388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown TWP, MI

Sources for this page

Verify at the official NPI Registry.