Organization Active NPI

Northwest Surgical Associates PC

  • Surgery Physician
  • Southfield, MI
National Provider Identifier
1710040068
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHWEST SURGICAL ASSOCIATES PC
Practice address
27209 Lahser
Suite 128
Southfield, MI 48034-8402
Phone
(248) 353-0200
Fax
(243) 353-1513
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Allen J Telmos, MD
Title
President
Phone
(248) 353-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

27209 Lahser
Suite 128
Southfield, MI 48034-8402

Mailing address

27209 Lahser
Suite 128
Southfield, MI 48034-8402
Phone (248) 353-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080729000573 MI Part B Supplier - Clinic/Group Practice 3476624701 Receives reassigned benefits from 6 practitioners
Practice locations: Southfield, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0900528Northwest Surgical Associates27209 Lahser Road Suite 128, Southfield, MI 48034Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1710040068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27209 LAHSER",
            "address_2": "SUITE 128",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348402",
            "telephone_number": "248-353-0200",
            "fax_number": "243-353-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27209 LAHSER",
            "address_2": "SUITE 128",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348402",
            "telephone_number": "248-353-0200",
            "fax_number": "243-353-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "TELMOS",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-353-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.