Regents of the University of Michigan

Organization Active NPI Physical Medicine & Rehabilitation Physician · Ann Arbor, MI

NPI 1790719532 · NPPES record last updated May 3, 2021

Key facts

NPI
1790719532
Entity type
Organization (NPI type 2)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Practice address
325 East Eisenhower Pkwy
Suite 100
Ann Arbor, MI 48108
Phone
(734) 936-7175
NPI assigned
Jul 10, 2006
Organization subpart
No

Authorized official

Name
David Christopher Miller
Title
President
Phone
(734) 936-3568

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 65

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

View all 65

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1070389University of Michigan
325 E Eisenhower Pkwy, Ann Arbor, MI 48108
Certificate of waiverJun 26, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031106000325 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 2,340 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Regents of Univ of Michigan (157 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208100000X Yes
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081H0002X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081N0008X
Spinal Cord Injury Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081P0004X
Pediatric Rehabilitation Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081P0010X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081P0301X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081P2900X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2081S0010X

Addresses

Primary practice location

325 East Eisenhower Pkwy
Suite 100
Ann Arbor, MI 48108

Mailing address

3621 S State St
Provider Enrollment
Ann Arbor, MI 48108
Phone (734) 647-5299

Other identifiers

IdentifierTypeStateIssuer
250H176210OtherMIBCBS

Other providers in Ann Arbor, MI

All providers in Ann Arbor, MI · Physical Medicine & Rehabilitation Physician in Michigan

Sources for this page

Verify at the official NPI Registry.