Organization Active NPI

Linda M Dubay MD PLLC

  • Surgery Physician
  • Novi, MI
National Provider Identifier
1679617419
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
LD053074 Issued in MI
Legal business name
LINDA M DUBAY MD PLLC
Practice address
26850 Providence Pkwy
Ste 504
Novi, MI 48374-1213
Phone
(248) 662-4333
Fax
(248) 662-3022
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Authorized official

Name
Dr. Linda M. Dubay, M. D.NPI 1770591786
Title
President/Physician
Phone
(248) 662-4333

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X LD053074 MI Primary

Addresses

Primary practice location

26850 Providence Pkwy
Ste 504
Novi, MI 48374-1213

Mailing address

26850 Providence Pkwy
Ste 504
Novi, MI 48374-1213
Phone (248) 662-4333

Other identifiers 12

IdentifierTypeStateIssuer
103881OtherMIGREAT LAKES
312461OtherMIPRORITY HEALTH
1679617419MedicaidMI
020F369860OtherMIBCBS GROUP
0206368471OtherMIBC
0206368471OtherMIBCN
F57526OtherMIHAP
020F369860OtherMIBCN GROUP
025832OtherMIMIDWEST HEALTH PLAN
4361872OtherMIAETNA
112457004OtherMIUNITED HEALTH PLAN
DP1484OtherMIRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080905000512 MI Part B Supplier - Clinic/Group Practice 9537235171 Receives reassigned benefits from 1 practitioner
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

22250 Providence Dr
Ste 700
Southfield, MI 48075
Phone (248) 559-5115

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1679617419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "STE 504",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741213",
            "telephone_number": "248-662-4333",
            "fax_number": "248-662-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "STE 504",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741213",
            "telephone_number": "248-662-4333",
            "fax_number": "248-662-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA M DUBAY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "DUBAY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "248-662-4333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "LD053074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "103881",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRORITY HEALTH",
            "identifier": "312461",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679617419",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "020F369860",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "0206368471",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "0206368471",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "F57526",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "020F369860",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "025832",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4361872",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLAN",
            "identifier": "112457004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP1484",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.