Organization Active NPI

Medical Center Pediatrics PLLC

  • Pediatrics Physician
  • Bingham Farms, MI
National Provider Identifier
1801992698
Registry record updated Mar 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEDICAL CENTER PEDIATRICS PLLC
Practice address
30400 Telegraph Rd
Suite 101
Bingham Farms, MI 48025
Phone
(248) 642-5437
Fax
(248) 642-5456
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2022

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

Authorized official

Name
Susan Sauber, MDNPI 1861504334
Title
Manager
Phone
(248) 642-5437

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

30400 Telegraph Rd
Suite 101
Bingham Farms, MI 48025

Mailing address

30400 Telegraph Rd
Suite 101
Bingham Farms, MI 48025
Phone (248) 642-5437

Other identifiers 1

IdentifierTypeStateIssuer
350F317240OtherMIBCBS M

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0369537Medical Center Pediatrics PLLC30400 Telegraph Road Suite 101, Bingham Farms, MI 48025AccreditationJun 2, 2027

National Provider Directory

National Provider Directory

Locations

30400 Telegraph Rd
Ste 101
Bingham Farms, MI 48025
Phone (248) 642-5437

31600 Telegraph Rd
Ste 100
Bingham Farms, MI 48025
Phone (248) 642-5437

5793 W Maple Rd
Ste 153
West Bloomfield, MI 48322
Phone (248) 539-7726

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647648000000",
    "number": "1801992698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD",
            "address_2": "SUITE 101",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "48025",
            "telephone_number": "248-642-5437",
            "fax_number": "248-642-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD",
            "address_2": "SUITE 101",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "48025",
            "telephone_number": "248-642-5437",
            "fax_number": "248-642-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A",
        "authorized_official_last_name": "SAUBER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-642-5437",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS M",
            "identifier": "350F317240",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.