NPIMap

Organization Active NPI

Neuro Team One PLLC

  • Neurology Physician
  • Bingham Farms, MI
National Provider Identifier
1699227116
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301088851 Issued in MI
Legal business name
NEURO TEAM ONE PLLC
Practice address
31500 Telegraph Rd Ste 115
Bingham Farms, MI 48025-4302
Phone
(248) 621-9100
NPI assigned
Nov 1, 2016
Last updated
Jul 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Andrew Rathnasamy Xavier, MDNPI 1124097225
Title
Member
Phone
(248) 621-9100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X 4301088851 MI Primary
Vascular Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084V0102X 4301088851 MI

Addresses

Primary practice location

31500 Telegraph Rd Ste 115
Bingham Farms, MI 48025-4302

Mailing address

6632 Telegraph Rd Ste 204
Bloomfield Hills, MI 48301-3012

Other identifiers 1

IdentifierTypeStateIssuer
4950019MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171016002730 MI Part B Supplier - Clinic/Group Practice 0143596379 Receives reassigned benefits from 17 practitioners
Practice locations: Bingham Farms, MI; Ypsilanti, MI; Bloomfield Hills, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1699227116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6632 TELEGRAPH RD STE 204",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 TELEGRAPH RD STE 115",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254302",
            "telephone_number": "248-621-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO TEAM ONE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "XAVIER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "RATHNASAMY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-621-9100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301088851",
            "primary": true
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MI",
            "license": "4301088851",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4950019",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.