NPIMap

Individual provider Active NPI

Michelle Renee Egan, DO

  • Family Medicine Physician
  • Beverly Hills, MI
National Provider Identifier
1689136152
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101026823 Issued in MI
Practice address
17392 W 13 Mile Rd
Beverly Hills, MI 48025-5438
Phone
(248) 646-8166
Fax
(248) 646-8176
NPI assigned
Apr 3, 2019
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101026823 MI Primary

Addresses

Primary practice location

17392 W 13 Mile Rd
Beverly Hills, MI 48025-5438

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1865

Other practice location 1

36500 S Gratiot Ave
Clinton Twp, MI 48035-1772
Phone (586) 493-3727

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address megan4563298@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912000733 MI Practitioner - Family Practice 1456688720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

17392 W 13 Mile Rd
Corewell Health Internal Medicine
Beverly Hills, MI 48025-5438
Phone (248) 646-8166

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026823MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Aug 31, 2022 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Aug 31, 2022 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

17392 W 13 Mile Rd
Beverly Hills, MI 48025
Phone (248) 258-8740

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: megan1232356@epic00.shdirect.org
  • Direct secure messaging: megan4563298@direct.beaumont.edu

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1689136152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17392 W 13 MILE RD",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255438",
            "telephone_number": "248-646-8166",
            "fax_number": "248-646-8176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36500 S Gratiot Ave",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480351772",
            "country_code": "US",
            "telephone_number": "586-493-3727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGAN",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101026823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "megan4563298@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "17392 W 13 Mile Rd",
            "city": "Beverly Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480255438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly Hills, MI

Sources for this page

Verify at the official NPI Registry.