NPIMap

Organization Active NPI

Associated Orthopedists of Detroit, PC

  • Orthopaedic Surgery Physician
  • Shelby Township, MI
National Provider Identifier
1669653606
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ASSOCIATED ORTHOPEDISTS OF DETROIT, PC
Practice address
50505 Schoenherr Rd
Suite 120
Shelby Township, MI 48315-3140
Phone
(586) 412-1411
Fax
(586) 412-4626
NPI assigned
Nov 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Jamie Johnson
Title
Credentialing Manager
Phone
(586) 710-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

50505 Schoenherr Rd
Suite 120
Shelby Township, MI 48315-3140

Mailing address

50505 Schoenherr Rd
Suite 120
Shelby Township, MI 48315-3140
Phone (586) 412-1411

Other identifiers 1

IdentifierTypeStateIssuer
200E076460OtherMIBCBSM PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930006817 MI DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Sports MedicineDME Supplier - Independently-Practicing Physical Therapist 3375440134 Practice locations: Shelby TWP, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Associated Orthopedists4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1669653606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "SUITE 120",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-412-1411",
            "fax_number": "586-412-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "SUITE 120",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-412-1411",
            "fax_number": "586-412-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED ORTHOPEDISTS OF DETROIT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "586-710-2307"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "200E076460",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.