Mary C Mentag, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

4704334986 Issued in MI

Practice address

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Phone

(313) 516-2725

Fax

(313) 516-2735

NPI assigned

Jul 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmentag446463@direct.hfhs.org

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.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801

  Single Specialty

  Medicare reassignment NPD
• Henr Y Ford Health System

  • Advanced Practice Midwife
  • Detroit, MI
  • NPI 1902982093

  Single Specialty

  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1801569223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "313-516-2725",
            "fax_number": "313-516-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "313-516-2725",
            "fax_number": "313-516-2735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 S Lapeer Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Orion",
            "state": "MI",
            "postal_code": "483601437",
            "country_code": "US",
            "telephone_number": "248-693-0543",
            "fax_number": "248-693-3683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENTAG",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704334986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Anthony Melchiode, M.D.
• Melissa McBrien, M.D., P.L.L.C.
• Sandra Mellin, CSW
• Melvin F Cohen M.D. PC
• Risa Rae Mendelson, MA, LLPC, COTA
• Manda Marie Meram, PA-C
• Maxine Meram
• Kortney Mercer, MA,ERT,PCT
• Mercy Diagnostic Services Inc
• Suzanne Merkle, MD

• Advanced Practice Midwife in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Advanced Practice Midwife in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.