Michigan Primary Care PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ZP064027 Issued in MI

Legal business name

MICHIGAN PRIMARY CARE PLLC

Practice address

41400 Dequindre Rd Ste 121
Sterling Heights, MI 48314

Phone

(586) 843-3815

Fax

(586) 843-3920

NPI assigned

Apr 23, 2010

Last updated

May 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Brown, CPC

Title

Billing Manager

Phone

(586) 251-2095

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Gateway Medical Center PLLC

  dba Primary Care of Michigan

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1750999751
  NPPES parent name

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.

• Rita Karana Kathawa, M.D.

  • Obesity Medicine (Internal Medicine) Physician
  • Sterling Heights, MI
  • NPI 1427584812
  Medicare reassignment Care Compare group NPD
• Tyler James Mariage, FNP-BC

  • Family Nurse Practitioner
  • Eastpointe, MI
  • NPI 1154195923

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Colleen Miller, NP

  • Gerontology Nurse Practitioner
  • Eastpointe, MI
  • NPI 1285161430
  Medicare reassignment Care Compare group NPD
• Zbigniew Purzycki, M.D.

  • Internal Medicine Physician
  • Sterling Heights, MI
  • NPI 1942241393
  Medicare reassignment Care Compare group NPD
• Freny Sebastian, MD

  • Internal Medicine Physician
  • Eastpointe, MI
  • NPI 1629698535
  Medicare reassignment Care Compare group NPD
• Aleksandra Tasevski, NP

  • Family Nurse Practitioner
  • Eastpointe, MI
  • NPI 1871013334
  Medicare reassignment Care Compare group NPD
• Anna Malgorzata Adams, DO

  • Internal Medicine Physician
  • Ypsilanti, MI
  • NPI 1306306329
  Medicare reassignment NPD
• Gary G Bill, MD

  • Internal Medicine Physician
  • Eastpointe, MI
  • NPI 1326140179
  Medicare reassignment NPD
• Michael G Gifford, MD

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1871056358
  Medicare reassignment NPD
• Stephanie N. Shaheen, M.S., PA-C

  • Physician Assistant
  • Troy, MI
  • NPI 1669857017
  Medicare reassignment
• Magdalena Alison Oleksy, ANP-BC

  • Adult Health Nurse Practitioner
  • Sterling HTS, MI
  • NPI 1205139755
  NPD
• Ghiath Tayeb, MD

  • Gastroenterology Physician
  • Rochester Hills, MI
  • NPI 1447236401
  NPD

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1669799128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41400 DEQUINDRE RD STE 121",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143751",
            "telephone_number": "586-843-3815",
            "fax_number": "586-843-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41400 DEQUINDRE RD STE 121",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48314",
            "telephone_number": "586-843-3815",
            "fax_number": "586-843-3920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17000 E 10 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Eastpointe",
            "state": "MI",
            "postal_code": "480211263",
            "country_code": "US",
            "telephone_number": "586-563-5555",
            "fax_number": "586-563-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIGAN PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "586-251-2095",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "DM050196",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "ZP064027",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301064027",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669799128",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Medicine Specialists PLLC
• Michigan Medirides LLC
• Michigan Pain Clinic Associates PC
• Michigan Periodontics & Implants (Mi Perio PC)
• Michigan Physical Therapy and Rehab, LLC.
• Michigan Rheumatology Center
• Leona Mickles-Burnes, ACSW, PHD., LMSW
• Laura Mico
• Midwest Hand Therapy Inc.
• Midwest Medical Associates Inc

• Specialist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.