NPIMap

Individual provider Active NPI

Brandon David Ahlgren, MD

  • Rheumatology Physician
  • Detroit, MI
National Provider Identifier
1700415874
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4351051545 Issued in MI
Practice address
4201 Saint Antoine St # 4H
Detroit, MI 48201-2153
Phone
(248) 860-1568
NPI assigned
Apr 2, 2020
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 4351051545 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St # 4H
Detroit, MI 48201-2153

Mailing address

4201 Saint Antoine St # 4H
Detroit, MI 48201-2153

Other practice location 1

3537 W Front St Ste A
Traverse City, MI 49684-7942
Phone (231) 935-2525

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
I20250414000360 MI Practitioner - Internal Medicine 2466862115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

3537 W Front St
Suite a
Traverse City, MI 49684-7942
Phone (231) 935-8330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351051545MIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center Rheumatology CurrentSince Apr 3, 2025 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Munson Medical Center CurrentSince Apr 3, 2025 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

3537 W Front St
Ste A
Traverse City, MI 49684
Phone (231) 935-2525

Interoperability endpoints

  • Direct secure messaging: bahlgren125847@direct.luhs.org
  • Direct secure messaging: bahlgren528714@direct.hfhs.org

Organizations & group practices 4

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 6

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1700415874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 4H",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 4H",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "248-860-1568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3537 W Front St Ste A",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847942",
            "country_code": "US",
            "telephone_number": "231-935-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHLGREN",
        "first_name": "BRANDON",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4351051545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.