NPIMap

Individual provider Active NPI

Michelle Marie Reicosky Brewer, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Novi, MI
National Provider Identifier
1629282793
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101015782 Issued in MI
Practice address
42350 Grand River Ave
Novi, MI 48375-1838
Phone
(248) 697-2942
Fax
(248) 436-6628
NPI assigned
May 9, 2007
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101015782 MI Primary

Addresses

Primary practice location

42350 Grand River Ave
Novi, MI 48375-1838

Mailing address

42350 Grand River Ave
Novi, MI 48375-1838
Phone (248) 697-2942

Other identifiers 1

IdentifierTypeStateIssuer
5181105MedicaidMI

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
I20070712000353 MI Practitioner - Physical Medicine and Rehabilitation 5395845838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restorative Physical Medicine PLLCGroup PAC ID 0042631194, 20 clinicians

Practice addresses (Care Compare)

42350 Grand River Ave
Novi, MI 48375-1838
Phone (248) 697-2942

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101015782MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Physical Medicine & Rehabilitation CurrentSince Oct 1, 2008 Accepting new patients
W.a. Foote Memorial Hospital CurrentSince Oct 1, 2008 Accepting new patients
W. a. Foote Memorial Hospital Current Accepting new patients
Henry Ford Pathology Current Accepting new patients

Locations

1201 E Michigan Ave
Ste 300
Jackson, MI 49201
Phone (517) 205-1431

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

Interoperability endpoints

  • Direct secure messaging: mbrewer450893@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1629282793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42350 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751838",
            "telephone_number": "248-697-2942",
            "fax_number": "248-436-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42350 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751838",
            "telephone_number": "248-697-2942",
            "fax_number": "248-436-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "MICHELLE",
        "middle_name": "MARIE REICOSKY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101015782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5181105",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.