Borivoje Trifunovic, MD
Individual provider Active NPI Internal Medicine Physician · Roseville, MI
NPI 1730167644 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1730167644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 4301080193 (MI)
- Practice address
- 25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959 - Phone
- (586) 772-2600
- Fax
- (586) 772-5289
- NPI assigned
- Jan 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covenant Medical Center, Inc.
Practice addresses (Care Compare)
700 Cooper Ave
Saginaw, MI 48602-5383
Phone (989) 583-4220
Hospital & facility affiliations
- Covenant Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050919000293 | MI | Practitioner - Internal Medicine | 6507899671 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301080193 | MI | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Services Corporation | Current | Accepting new patients | |
| Covenant Medical Center, Inc. | Internal Medicine | Current |
Accepting new patients |
| Covenant Medical Center, Inc | Internal Medicine | Current |
Accepting new patients |
| Iha Health Service Corporation | Current |
Accepting new patients | |
| Largo GLM PLLC | Internal Medicine | Current |
Accepting new patients |
| Hospitalist Physicians Medical Group of Michigan, PC | Current |
Accepting new patients | |
| Innovation Medicine, PLLC | Internal Medicine | Current |
Accepting new patients |
| Patrick a. Charles MD PC | Internal Medicine | Current |
Accepting new patients |
| Iha Health Services Corporation | Current |
Accepting new patients | |
| Covenant Medical Center, Inc. | Current | Accepting new patients | |
| Hospitalist Physicians Medical Group of Michigan, PC | Hospitalist | Current |
Accepting new patients |
| Great Lakes Medicine, PLC | Internal Medicine | Past | Accepting new patients |
| Covenant Medical Center, Inc. | Past | Accepting new patients |
Locations
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248
18601 Mack Ave
Ste 2
Grosse Pointe, MI 48236
Phone (313) 640-1250
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
25710 Kelly Rd
Ste 3
Roseville, MI 48066
Phone (586) 291-5669
25710 Kelly Rd
Ste 1
Roseville, MI 48066
Phone (586) 772-2600
1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220
700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000
2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000
Interoperability endpoints
- btrifunovich220846@direct.hfhs.org
- btrifunovic174901@direct.covenanthealthcare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301080193 | MI | Yes |
| Hospitalist Physician | 208M00000X | 4301080193 | MI |
Addresses
Primary practice location
25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959
Mailing address
25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959
Phone (586) 772-2600
Other practice location 1
1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-4220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4772374 | Medicaid | MI | |
| 1730167644 | Other | MI | NPI |
| 4784212 | Medicaid | MI |
Other providers in Roseville, MI
- Carl Toubassi
- Roy Toubassi
- Beverly Ann Towner
- Jimmy Tran
- Angela Trent
- True to Hearts Home Health Care LLC
- Trusted Hands Inc
- Josie Turner
- Tavia Turner
- Tutak Chiropractic
All providers in Roseville, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.