NPIMap

Organization Active NPI

Impg PLLC

Doing business as Elite Health Associates

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1629848957
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IMPG PLLC
Doing business as
Elite Health Associates
Practice address
1622 Sherwood CT
Dearborn, MI 48124-4073
Phone
(313) 929-0007
NPI assigned
Jan 8, 2024
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Christine Michalik
Title
Credentialing Specialist
Phone
(248) 663-2021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1622 Sherwood CT
Dearborn, MI 48124-4073

Mailing address

1622 Sherwood CT
Dearborn, MI 48124-4073

Other names 1

  • Elite Health Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180301002396 MI Part B Supplier - Clinic/Group Practice 2567723885 Receives reassigned benefits from 12 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1629848957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 SHERWOOD CT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 SHERWOOD CT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244073",
            "telephone_number": "313-929-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPG PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "MICHALIK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "248-663-2021"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Health Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 1, 2024; 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.