Individual provider Active NPI

Archi Trivedi, MD

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1649246893
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301068217 Issued in MI
Practice address
28111 Hoover Rd
Suite 3a
Warren, MI 48093-4153
Phone
(586) 573-9365
Fax
(586) 573-9389
NPI assigned
Feb 27, 2006
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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 4301068217 MI Primary

Addresses

Primary practice location

28111 Hoover Rd
Suite 3a
Warren, MI 48093-4153

Mailing address

28111 Hoover Rd
Ste 2a
Warren, MI 48093-4153
Phone (586) 573-9365

Other identifiers 1

IdentifierTypeStateIssuer
4173744MedicaidMI

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
I20100423000845 MI Practitioner - Internal Medicine 9234266198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28111 Hoover Rd
Suite 2a
Warren, MI 48093-4153
Phone (586) 573-9365

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301068217MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Medical Associates PC Internal Medicine CurrentSince Jul 25, 2000 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients

Locations

28111 Hoover Rd
Ste 2A
Warren, MI 48093
Phone (586) 573-9365

28111 Hoover Rd
Ste 3A
Warren, MI 48093
Phone (586) 573-9365

Interoperability endpoints

  • Direct secure messaging: atrivedi1155944@direct.hfhs.org

Organizations & group practices 2

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 4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1649246893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28111 HOOVER RD",
            "address_2": "STE 2A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934153",
            "telephone_number": "586-573-9365",
            "fax_number": "586-573-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28111 HOOVER RD",
            "address_2": "SUITE 3A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934153",
            "telephone_number": "586-573-9365",
            "fax_number": "586-573-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "ARCHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301068217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4173744",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.