Organization Active NPI

Cedar Bay Medicine PC

Doing business as North Valley Internal Medicine PC

  • Internal Medicine Physician
  • Highland, MI
National Provider Identifier
1669212114
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CEDAR BAY MEDICINE PC
Doing business as
North Valley Internal Medicine PC
Practice address
2330 S Milford Rd Ste 120
Highland, MI 48357-4982
Phone
(248) 676-9060
NPI assigned
May 30, 2024
Last updated
Jul 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Brandon Genson, DONPI 1548585045
Title
Owner
Phone
(248) 676-9060

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
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2330 S Milford Rd Ste 120
Highland, MI 48357-4982

Mailing address

2330 S Milford Rd Ste 120
Highland, MI 48357-4982

Other names 1

  • North Valley Internal Medicine PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240802001990 MI Part B Supplier - Clinic/Group Practice 0143767533 Receives reassigned benefits from 7 practitioners
Practice locations: Highland, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2322091Cedar Bay Medicine PC2330 S Milford Road Suite 120, Highland, MI 48357Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1669212114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S MILFORD RD STE 120",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S MILFORD RD STE 120",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574982",
            "telephone_number": "248-676-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR BAY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "GENSON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-676-9060",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Valley Internal Medicine PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Valley Internal Medicine PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.