Individual provider Active NPI

Bruce E West, M.D.

  • Obstetrics & Gynecology Physician
  • Southfield, MI
National Provider Identifier
1629077763
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301051847 Issued in MI
Practice address
27177 Lahser Rd
Ste. 100
Southfield, MI 48034-4714
Phone
(248) 352-8970
Fax
(248) 352-8933
NPI assigned
Jul 20, 2005
Last updated
Oct 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301051847 MI Primary

Addresses

Primary practice location

27177 Lahser Rd
Ste. 100
Southfield, MI 48034-4714

Mailing address

27177 Lahser Rd
Ste. 100
Southfield, MI 48034-4714
Phone (248) 352-8970

Other identifiers 1

IdentifierTypeStateIssuer
4352119-10MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051121000374 MI Practitioner - Obstetrics/Gynecology 6507885456 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301051847MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luke OBGYN Care PC Obstetrics & Gynecology Current Accepting new patients
Lorna Thomas, M.D., P.C. PastSince May 2, 2017 Accepting new patients

Locations

29425 Northwestern Hwy
Ste 200
Southfield, MI 48034
Phone (248) 948-6900

Interoperability endpoints

  • Direct secure messaging: bwest2@direct.dmc.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1629077763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27177 LAHSER RD",
            "address_2": "STE. 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480344714",
            "telephone_number": "248-352-8970",
            "fax_number": "248-352-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27177 LAHSER RD",
            "address_2": "STE. 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480344714",
            "telephone_number": "248-352-8970",
            "fax_number": "248-352-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "BRUCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301051847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4352119-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.