Individual provider Active NPI

Heather M Gulish, M.S.N., C.U.N.P.

  • Nurse Practitioner
  • Saint Clair Shores, MI
National Provider Identifier
1679538318
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704180714 Issued in MI
Practice address
20952 E 12 Mile Rd
Suite 200
St Clair Shores, MI 48081-3200
Phone
(586) 771-4820
Fax
(586) 771-6620
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704180714 MI Primary

Addresses

Primary practice location

20952 E 12 Mile Rd
Suite 200
St Clair Shores, MI 48081-3200

Mailing address

20952 E 12 Mile Rd
Suite 200
St Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other identifiers 1

IdentifierTypeStateIssuer
500013142OtherMIRAILROAD MEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050509000347 MI Practitioner - Nurse Practitioner 9739129826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians

Practice addresses (Care Compare)

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

5701 Bow Pointe Dr
Suite 250
Clarkston, MI 48346-5405
Phone (248) 620-6660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.01
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704180714MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Institute of Urology PC CurrentSince May 2, 2005 Accepting new patients
Alliance Physician Services of Michigan, P.C. Nurse Practitioner CurrentSince May 2, 2005 Accepting new patients
Alliance Physician Services of Michigan, P.C. Nurse Practitioner Current Accepting new patients

Locations

5701 Bow Pointe Dr
Ste 250
Clarkston, MI 48346
Phone (248) 620-6660

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

11051 Hall Rd
Ste 200
Utica, MI 48317
Phone (586) 254-5759

Organizations & group practices 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1679538318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULISH",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "M.S.N., C.U.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704180714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500013142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.