Individual provider Active NPI

Miriam R Thomas, M.D.

  • Gastroenterology Physician
  • Ypsilanti, MI
National Provider Identifier
1689654725
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301069323 Issued in MI
Practice address
5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone
(734) 434-6262
Fax
(734) 712-2820
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 4301069323 MI Primary

Addresses

Primary practice location

5300 Elliott Dr
Ypsilanti, MI 48197-8632

Mailing address

5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone (734) 822-2826

Other identifiers 7

IdentifierTypeStateIssuer
0812048OtherMIBCBS INDIVIDUAL
0H14989OtherMIBCBS GROUP
028223OtherMIMIDWEST HEALTH PLAN
5560329OtherMICIGNA
7318554OtherMIAETNA
P00124944OtherMIMEDICARE RAILROAD PTAN
4620873MedicaidMI

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
I20040712000491 MI Practitioner - Internal MedicinePractitioner - Gastroenterology 0648258178 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

620 Byron Rd
Howell, MI 48843-1002
Phone (517) 545-5450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy109
Upper gastrointestinal (GI) endoscopy for acid reflux151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301069323MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Digestive Care LLC CurrentSince Mar 19, 2020 Accepting new patients
St Mary Mercy Hospital Current Accepting new patients
St Mary Mercy Hospital Professional Gastroenterology CurrentSince Nov 1, 2023 Accepting new patients
St Mary Mercy Hospital Crna Current Accepting new patients
St Mary Mercy Hospital Professional Current Accepting new patients

Locations

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

36650 5 Mile Rd
Livonia, MI 48154
Phone (734) 434-6262

36650 5 Mile Rd
Ste 101
Livonia, MI 48154
Phone (734) 434-6262

36650 5 Mile Rd
Ste 100
Livonia, MI 48154
Phone (734) 432-0314

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5300 Elliott Dr
Ypsilanti, MI 48197
Phone (734) 434-6262

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 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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1689654725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632",
            "telephone_number": "734-822-2826",
            "fax_number": "734-434-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632",
            "telephone_number": "734-434-6262",
            "fax_number": "734-712-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MIRIAM",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301069323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "0812048",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0H14989",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "028223",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5560329",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7318554",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P00124944",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4620873",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.