Organization Active NPI

Marcel R Elanjian D O. PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Dearborn, MI
National Provider Identifier
1629243290
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME007858 Issued in MI
Legal business name
MARCEL R ELANJIAN D O. PLLC
Practice address
2151 Monroe St
Dearborn, MI 48124-2922
Phone
(313) 561-5050
Fax
(313) 561-6061
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Marcel Richard Elanjian, D.O.NPI 1861485500
Title
Physician
Phone
(313) 561-6060

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
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X ME007858 MI Primary

Addresses

Primary practice location

2151 Monroe St
Dearborn, MI 48124-2922

Mailing address

2151 Monroe St
Dearborn, MI 48124-2922
Phone (313) 561-5050

Other identifiers 1

IdentifierTypeStateIssuer
2116337MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000733 MI Part B Supplier - Clinic/Group Practice 2961575477 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI; Taylor, MI

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1629243290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242922",
            "telephone_number": "313-561-5050",
            "fax_number": "313-561-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242922",
            "telephone_number": "313-561-5050",
            "fax_number": "313-561-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCEL R ELANJIAN D O. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "ELANJIAN",
        "authorized_official_first_name": "MARCEL",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "313-561-6060",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "ME007858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2116337",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.