NPIMap

Organization Active NPI

University Neurosurgical Associates PC

Doing business as Michigan Head and Spine Institute

  • Specialist
  • Southfield, MI
National Provider Identifier
1699761379
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UNIVERSITY NEUROSURGICAL ASSOCIATES PC
Doing business as
Michigan Head and Spine Institute
Practice address
29275 Northwestern Hwy
Ste 100
Southfield, MI 48034-1044
Phone
(248) 784-3708
Fax
(248) 784-3743
NPI assigned
Sep 27, 2005
Last updated
Sep 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Authorized official

Name
Robert R Johnson, M.D.NPI 1861489452
Title
President
Phone
(877) 784-3667

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
Specialist 174400000X NU Primary
Orthotic Fitter 225000000X NU

Addresses

Primary practice location

29275 Northwestern Hwy
Ste 100
Southfield, MI 48034-1044

Mailing address

29275 Northwestern Hwy
Ste 100
Southfield, MI 48034-1044
Phone (877) 784-3667

Other identifiers 2

IdentifierTypeStateIssuer
140F329410OtherMIBCBS
140F329410OtherBCBS

Other names 1

  • Michigan Head and Spine Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050127000624 MI Part B Supplier - Clinic/Group Practice 9739139759 Receives reassigned benefits from 74 practitioners
11 other NPIs on this enrollment
Practice locations: Southfield, MI; Ypsilanti, MI; Waterford, MI; Walled Lake, MI; Troy, MI; Trenton, MI; Royal Oak, MI; Pontiac, MI…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1699761379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY",
            "address_2": "STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341044",
            "telephone_number": "877-784-3667",
            "fax_number": "248-784-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY",
            "address_2": "STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341044",
            "telephone_number": "248-784-3708",
            "fax_number": "248-784-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY NEUROSURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-784-3667",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "140F329410",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "140F329410",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Head and Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michigan Head and Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.