NPIMap

Organization Active NPI

Advanced Critical Care Team PLLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Mount Clemens, MI
National Provider Identifier
1609519404
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
ADVANCED CRITICAL CARE TEAM PLLC
Practice address
215 North Ave
Mount Clemens, MI 48043-1716
Phone
(586) 871-2155
Fax
(586) 204-0169
NPI assigned
Apr 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Andrew Staricco, MDNPI 1750306742
Title
Ceo
Phone
(586) 871-2155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0200X Primary

Addresses

Primary practice location

215 North Ave
Mount Clemens, MI 48043-1716

Mailing address

215 North Ave
Mount Clemens, MI 48043-1716
Phone (586) 871-2155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220503002493 MI Part B Supplier - Clinic/Group Practice 0446647895 Receives reassigned benefits from 3 practitioners
Practice locations: Mount Clemens, MI

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1609519404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NORTH AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431716",
            "telephone_number": "586-871-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431716",
            "telephone_number": "586-871-2155",
            "fax_number": "586-204-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CRITICAL CARE TEAM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "STARICCO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "586-871-2155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.

Verify at the official NPI Registry.