NPIMap

Organization Active NPI

Reza Kahnamouei MD PLLC

Doing business as Total Care Physicians Group

  • Family Medicine Physician
  • Clinton Township, MI
National Provider Identifier
1619339918
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REZA KAHNAMOUEI MD PLLC
Doing business as
Total Care Physicians Group
Practice address
43361 Commons Dr
Clinton Township, MI 48038-1109
Phone
(586) 745-3006
NPI assigned
Mar 25, 2016
Last updated
Mar 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Authorized official

Name
Mrs. Emilie Marie Pineau
Title
Office Manager
Phone
(586) 745-3006

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

43361 Commons Dr
Clinton Township, MI 48038-1109

Mailing address

43361 Commons Dr
Clinton Township, MI 48038-1109
Phone (586) 745-3006

Other names 1

  • TOTAL CARE PHYSICIANS GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121018000309 MI Part B Supplier - Clinic/Group Practice 7911157425 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton TWP, MI; Imlay City, MI

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2038324Reza Kahnamouei MD PLLC43361 Commons Drive, Clinton Township, MI 48038Certificate of waiverMar 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Reza Kahnamouei MD PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1834 S Cedar St
Ste A
Imlay City, MI 48444
Phone (586) 745-3006

1834 S Cedar St
Ste B
Imlay City, MI 48444
Phone (810) 721-0000

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1619339918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43361 COMMONS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-745-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43361 COMMONS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-745-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA KAHNAMOUEI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "PINEAU",
        "authorized_official_first_name": "EMILIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-745-3006",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOTAL CARE PHYSICIANS GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.