Individual provider Active NPI

Brian Thomas Doyle, MD

  • Family Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1750677316
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301110561 Issued in MI
Practice address
405 Momany Dr
Saint Joseph, MI 49085-2178
Phone
(269) 982-1947
Fax
(269) 982-1950
NPI assigned
Jun 22, 2011
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301110561 MI Primary

Addresses

Primary practice location

405 Momany Dr
Saint Joseph, MI 49085-2178

Mailing address

405 Momany Dr
Suite 300
Saint Joseph, MI 49085-2178
Phone (269) 982-1947

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
I20160921001088 MI Practitioner - Family Practice 0648425173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brian T Doyle MD PLCGroup PAC ID 6709137250, 2 clinicians

Practice addresses (Care Compare)

405 Momany Dr
Saint Joseph, MI 49085-2178
Phone (269) 982-1947

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brian T Doyle MD PLC Family Medicine CurrentSince Jun 7, 2018 Accepting new patients
Matthew Campbell, MD, PLC Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Alimenti Family Medicine Family Medicine Current Accepting new patients

Locations

405 Momany Dr
Saint Joseph, MI 49085
Phone (269) 962-1947

405 Momany Dr
Ste 300
Saint Joseph, MI 49085

Interoperability endpoints

  • Direct secure messaging: bdoyle26640@lakeland.midirect.net

Organizations & group practices 3

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 4

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1750677316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MOMANY DR",
            "address_2": "SUITE 300",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852178",
            "telephone_number": "269-982-1947",
            "fax_number": "269-982-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MOMANY DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852178",
            "telephone_number": "269-982-1947",
            "fax_number": "269-982-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301110561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.