NPIMap

Organization Active NPI

Southfield Internists PC

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1760573075
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOUTHFIELD INTERNISTS PC
Practice address
16800 W 12 Mile Rd
Ste 205
Southfield, MI 48076-6334
Phone
(248) 559-0900
Fax
(248) 559-0011
NPI assigned
Sep 28, 2006
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Pratibha Modi, MDNPI 1184614349
Title
President
Phone
(248) 559-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MI Primary

Addresses

Primary practice location

16800 W 12 Mile Rd
Ste 205
Southfield, MI 48076-6334

Mailing address

16800 W 12 Mile Rd Ste 205
Southfield, MI 48076-6334
Phone (248) 559-0900

Other identifiers 1

IdentifierTypeStateIssuer
0F31723OtherMIBCBSM

National Provider Directory

National Provider Directory

Locations

16800 W 12 Mile Rd
Ste 205
Southfield, MI 48076
Phone (248) 559-0900

Practitioners & affiliated clinicians

Practitioners 7

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1760573075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 W 12 MILE RD STE 205",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480766334",
            "telephone_number": "248-559-0900",
            "fax_number": "248-559-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 W 12 MILE RD",
            "address_2": "STE 205",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480766334",
            "telephone_number": "248-559-0900",
            "fax_number": "248-559-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD INTERNISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "PRATIBHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-559-0900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F31723",
            "state": "MI"
        }
    ],
    "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 Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.