Individual provider Active NPI

Michael J Michael Jr., M.D.

  • Anesthesiology Physician
  • Grand Blanc, MI
National Provider Identifier
1730116500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301064575 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-6499
Fax
(810) 606-7245
NPI assigned
Jun 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301064575 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

2432 Genesys Pkwy
Grand Blanc, MI 48439-8069
Phone (810) 606-6499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408001208 MI Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 4587658034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novi Aas LLCGroup PAC ID 1557587847, 14 clinicians

Practice addresses (Care Compare)

25500 Meadowbrook Rd
Suite 110
Novi, MI 48375-1879
Phone (248) 477-2200

29201 Telegraph Rd
Suite 500
Southfield, MI 48034-7648
Phone (248) 569-5985

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Services, LLC Anesthesiology CurrentSince Oct 1, 2018 Accepting new patients
Northwestern Services, LLC Current Accepting new patients
Novi Aas LLC Anesthesiology CurrentSince Jul 19, 2021 Accepting new patients
Great Lakes Surgical Center Anesthesia, PLC Anesthesiology Past Accepting new patients
American Anesthesiology Associates of Michigan, PC Anesthesiology Past Accepting new patients
American Anesthesiology of Michigan PC Anesthesiology Past Accepting new patients
Northland Anesthesia Associates, PC Anesthesiology PastSince Jul 1, 1995 Accepting new patients

Locations

30055 Northwestern Hwy
Ste L-60
Farmington Hills, MI 48334
Phone (248) 265-6555

3800 Centennial Dr
Grass Lake, MI 49240
Phone (517) 701-3100

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730116500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398069",
            "telephone_number": "810-606-6499",
            "fax_number": "810-606-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-6499",
            "fax_number": "810-606-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301064575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.