Organization Active NPI

Cardiothoracic Surgery Specialists PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Southfield, MI
National Provider Identifier
1780464875
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CARDIOTHORACIC SURGERY SPECIALISTS PLLC
Practice address
22250 Providence Dr Ste 206
Southfield, MI 48075-6210
Phone
(248) 621-9777
NPI assigned
Oct 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Michael Lee, MDNPI 1275590523
Title
MD
Phone
(248) 621-9777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

22250 Providence Dr Ste 206
Southfield, MI 48075-6210

Mailing address

2392 Lake Angelus LN
Lake Angelus, MI 48326-1008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231020000644 MI Part B Supplier - Clinic/Group Practice 3577919059 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1780464875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2392 LAKE ANGELUS LN",
            "city": "LAKE ANGELUS",
            "state": "MI",
            "postal_code": "483261008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 206",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756210",
            "telephone_number": "248-621-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOTHORACIC SURGERY SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "248-621-9777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.