Organization Active NPI

Sunrise Medical Services, P.C.

  • Community Health Worker
  • Pontiac, MI
National Provider Identifier
1710201470
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
4301086699 Issued in MI
Legal business name
SUNRISE MEDICAL SERVICES, P.C.
Practice address
989 University Dr
Suite 104
Pontiac, MI 48342-1885
Phone
(248) 996-5284
NPI assigned
Mar 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Authorized official

Name
Dr. Carmen L Cardona, M.D.NPI 1851519433
Title
Medical Doctor
Phone
(248) 996-5284

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 172V00000X 4301086699 MI Primary

Addresses

Primary practice location

989 University Dr
Suite 104
Pontiac, MI 48342-1885

Mailing address

989 University Dr
Suite 104
Pontiac, MI 48342-1885
Phone (248) 996-5284

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110218000247 MI Part B Supplier - Clinic/Group Practice 5698956035 Receives reassigned benefits from 1 practitioner
Practice locations: Pontiac, MI

National Provider Directory

National Provider Directory

Locations

989 University Dr
Ste 102
Pontiac, MI 48342
Phone (248) 499-6590

989 University Dr
Ste 104
Pontiac, MI 48342
Phone (248) 499-6590

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1710201470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 UNIVERSITY DR",
            "address_2": "SUITE 104",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421885",
            "telephone_number": "248-996-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 UNIVERSITY DR",
            "address_2": "SUITE 104",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421885",
            "telephone_number": "248-996-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE MEDICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "CARDONA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "248-996-5284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "4301086699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.