Theoria Medical

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THEORIA MEDICAL

Practice address

41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818

Phone

(248) 860-4634

Fax

(248) 282-5044

NPI assigned

Jul 6, 2018

Reactivated

Aug 11, 2021

Last updated

Feb 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Svetlana Vinokur

Title

Cfo

Phone

(847) 275-9504

Specialties & licenses 8

Addresses

Other identifiers 1

Other names 1

• Justin P Direzze MD SOLE MBR Other name

Medicare fee-for-service enrollment

Enrolled in MI, NC, NH, MN, TN, KY, IN, TX, WI, MT, SC, AZ, GA, PA, VT, CO, MO, KS, IL, IA, LA, VA, MA, NE, AL, DC26 enrollments

Enrollment records 26

Other NPIs on the same Medicare enrollment 1

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

• Theoria Medical

  dba Theoria Primary Care

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946

  O20181004002127

  Same enrollment

Locations (25 of 51)

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Franklin County Rehab Center, LLC

  • Skilled Nursing Facility
  • Saint Albans, VT
  • NPI 1083601975

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• The Villa Rehab Center

  • Skilled Nursing Facility
  • Saint Albans, VT
  • NPI 1235680133

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Villa Rehab Center

  dba Redstone Villa Nursing Home

  • Skilled Nursing Facility
  • Saint Albans, VT
  • NPI 1700873718

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1,433

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelechi Akubukwe

  • Primary Care Nurse Practitioner
  • Novi, MI
  • NPI 1437763406

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michael Amlog, M.D.

  • Family Medicine Physician
  • Ann Arbor, MI
  • NPI 1215196225
  Medicare reassignment Care Compare group NPD
• Melody Anne Angel, MD

  • Family Medicine Physician
  • Lansing, MI
  • NPI 1770662025
  Medicare reassignment Care Compare group NPD
• Eriko Apriliando, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Southfield, MI
  • NPI 1528679305
  Medicare reassignment Care Compare group NPD
• Celestine Mba Arreytta

  • Family Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1811784705

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Muhammad Asad Arshad, M.B.B.S, MD

  • General Practice Physician
  • Tawas City, MI
  • NPI 1932595105
  Medicare reassignment Care Compare group NPD
• Caitlin Aumann, NP

  • Family Nurse Practitioner
  • Saginaw, MI
  • NPI 1699140475
  Medicare reassignment Care Compare group NPD
• Molly Marie Bailey, NP-C

  • Nurse Practitioner
  • Grand Rapids, MI
  • NPI 1972172054
  Medicare reassignment Care Compare group NPD
• Omolola Beaird

  • Adult Health Nurse Practitioner
  • Novi, MI
  • NPI 1558960179
  Medicare reassignment Care Compare group NPD
• Azhar Berry, MSN, APRN, FNP-C

  • Adult Health Nurse Practitioner
  • Dearborn Heights, MI
  • NPI 1841804424
  Medicare reassignment Care Compare group NPD
• Karen M Birt, CNP

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1518165802
  Medicare reassignment Care Compare group NPD
• Thomas L Bossi, DO

  • Family Medicine Physician
  • Davison, MI
  • NPI 1346342235
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1609362375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "248-860-4634",
            "fax_number": "248-282-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "248-860-4634",
            "fax_number": "248-282-5044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Omni Lake Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "OH",
            "postal_code": "442362856",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Claremont St",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013584",
            "country_code": "US",
            "telephone_number": "406-752-7622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7929 Westpark Dr",
            "address_purpose": "LOCATION",
            "city": "Tysons",
            "state": "VA",
            "postal_code": "221024247",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4150 W Republic Rd",
            "address_purpose": "LOCATION",
            "city": "Battlefield",
            "state": "MO",
            "postal_code": "656197111",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1538 N Old Castle Rd",
            "address_purpose": "LOCATION",
            "city": "Nixa",
            "state": "MO",
            "postal_code": "657149902",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3002 John Duffy Dr",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648041656",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1520 E Bates",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658048425",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6301 Lincoln Hwy",
            "address_purpose": "LOCATION",
            "city": "Matteson",
            "state": "IL",
            "postal_code": "604431568",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1537 NE Cedar St",
            "address_purpose": "LOCATION",
            "city": "Jensen Beach",
            "state": "FL",
            "postal_code": "349574808",
            "country_code": "US",
            "telephone_number": "772-332-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38130 Pretty Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335401419",
            "country_code": "US",
            "telephone_number": "813-779-4501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Hills and Dales Farm Rd",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302403805",
            "country_code": "US",
            "telephone_number": "770-312-6744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16255 Chesterfield Pkwy W",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630174824",
            "country_code": "US",
            "telephone_number": "248-660-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THEORIA MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "deactivation_date": "2021-08-09",
        "reactivation_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "VINOKUR",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-275-9504"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0411248",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Justin P Direzze MD SOLE MBR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Novi, MI
• Providers in Novi, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.