Individual provider Active NPI

Michelle M McLean, MD

  • Emergency Medicine Physician
  • Saginaw, MI
National Provider Identifier
1770696098
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301080009 Issued in MI
Practice address
900 Cooper Street
Saginaw, MI 48602
Phone
(989) 583-6122
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301080009 MI Primary

Addresses

Primary practice location

900 Cooper Street
Saginaw, MI 48602

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-6122

Other identifiers 1

IdentifierTypeStateIssuer
4758105MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmcleanmd1400@direct.covenanthealthcare.com

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
I20050504000540 MI Practitioner - Emergency Medicine 6406896919 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301080009MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deckerville Community Hospital, Inc CurrentSince Feb 7, 2017 Accepting new patients
Covenant Medical Center, Inc CurrentSince Jul 1, 2005 Accepting new patients
Covenant Medical Center, Inc. Emergency Medicine Current Accepting new patients
Covenant Medical Center, Inc. CurrentSince Jul 1, 2005 Accepting new patients
Deckerville Community Hospital, Inc. Emergency Medicine CurrentSince Feb 7, 2017 Accepting new patients

Locations

3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835

16440 Gratiot Rd
Hemlock, MI 48626
Phone (989) 583-0660

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

5570 State St
Saginaw, MI 48603
Phone (989) 583-0100

Interoperability endpoints

  • Direct secure messaging: mmcleanmd1400@direct.covenanthealthcare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1770696098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COOPER STREET",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48602",
            "telephone_number": "989-583-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301080009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4758105",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcleanmd1400@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "900 Cooper Street",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.