NPIMap

Organization Active NPI

Michigan Institute of Urology PC

  • Nurse Practitioner
  • Saint Clair Shores, MI
National Provider Identifier
1801018338
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MICHIGAN INSTITUTE OF UROLOGY PC
Practice address
20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone
(586) 771-4820
Fax
(586) 771-7960
NPI assigned
May 3, 2007
Organization subpart
Yes
Parent organization
MICHIGAN INSTITUTE OF UROLOGY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Alphonse Santino, MD
Title
President
Phone
(586) 771-4820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200

Mailing address

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other identifiers 1

IdentifierTypeStateIssuer
CB9133OtherMIRAILROAD MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Wayne Macomb Urolog24 organizations share this tax ID, including this one
Part of
Wayne Macomb Urolog

Other organizations with this tax ID 23

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

View all 23

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1801018338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INSTITUTE OF UROLOGY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN INSTITUTE OF UROLOGY PC",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "SANTINO",
        "authorized_official_first_name": "ALPHONSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-771-4820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB9133",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.