Individual provider Active NPI

Garret Justin Holcomb, M.D.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1679987549
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301114188 Issued in MI
Practice address
5841 S Maryland Ave
MC 2050
Chicago, IL 60637-1447
Phone
(773) 834-0598
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 4301114188 MI Primary
Obstetrics & Gynecology Physician 207V00000X 036142240 IL

Addresses

Primary practice location

5841 S Maryland Ave
MC 2050
Chicago, IL 60637-1447

Mailing address

36561 Harper Ave
Clinton Township, MI 48035-2012

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712002861 MI Practitioner - Obstetrics/Gynecology 8628371903 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

36500 S Gratiot Ave
Clinton Township, MI 48035-1772

36561 Harper Ave
Clinton Township, MI 48035-2012
Phone (586) 792-5740

37399 Garfield Rd
Clinton Township, MI 48036-3672

44200 Garfield Rd
Suite 164
Clinton Township, MI 48038-1142
Phone (586) 412-5117

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group Single Specialty CurrentSince Sep 24, 2021 Accepting new patients
VHS Physicians of Michigan Single Specialty CurrentSince Jun 26, 2018 Accepting new patients
McLaren Macomb Single Specialty CurrentSince May 14, 2021 Accepting new patients
McLaren Medical Group Single Specialty CurrentSince Sep 24, 2021 Accepting new patients
McLaren Medical Group Past Accepting new patients
McLaren Macomb Past Accepting new patients

Locations

32901 23 Mile Rd
Ste 120
Chesterfield, MI 48047
Phone (586) 725-4604

51086 Fairchild Rd
Ste A
Chesterfield, MI 48051
Phone (586) 725-4604

36561 Harper Ave
Clinton Twp, MI 48035
Phone (586) 791-0620

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

36500 S Gratiot Ave
Ste 202
Clinton Twp, MI 48035
Phone (586) 493-3727

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

44200 Garfield Rd
Ste 164
Clinton Twp, MI 48038
Phone (586) 412-5117

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

6001 W Outer Dr
Ste 400
Detroit, MI 48235
Phone (313) 966-4200

6001 W Outer Dr
Detroit, MI 48235
Phone (313) 341-1431

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1679987549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36561 HARPER AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480352012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 2050",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-834-0598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "GARRET",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301114188",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036142240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.