NPIMap

Individual provider Active NPI

Tammi Cooper, M.D.

  • Internal Medicine Physician
  • West Bloomfield, MI
National Provider Identifier
1619952975
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301069455 Issued in MI
Practice address
5821 W Maple Rd
Suite 190
West Bloomfield, MI 48322-2275
Phone
(248) 855-0407
Fax
(248) 855-1323
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301069455 MI Primary

Addresses

Primary practice location

5821 W Maple Rd
Suite 190
West Bloomfield, MI 48322-2275

Mailing address

5821 W Maple Rd
Suite 190
West Bloomfield, MI 48322-2275
Phone (248) 855-0407

Other identifiers 3

IdentifierTypeStateIssuer
0633928OtherMIBCBS INDIVIDUAL
1619952975MedicaidMI
110F375900OtherMIBLUE SHIELD

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
I20100611000753 MI Practitioner - Internal Medicine 6507995461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

5821 W Maple Rd
Suite 190
West Bloomfield, MI 48322-2275
Phone (248) 855-0407

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
Michigan Healthcare Professionals PC Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

5821 W Maple Rd
Ste 190
West Bloomfield, MI 48322
Phone (248) 855-0407

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1619952975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 W MAPLE RD",
            "address_2": "SUITE 190",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222275",
            "telephone_number": "248-855-0407",
            "fax_number": "248-855-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 W MAPLE RD",
            "address_2": "SUITE 190",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222275",
            "telephone_number": "248-855-0407",
            "fax_number": "248-855-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TAMMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301069455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "0633928",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619952975",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "110F375900",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.