NPIMap

Organization Active NPI

William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
National Provider Identifier
1811044878
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
WILLIAM BEAUMONT HOSPITAL
Doing business as
William Beaumont Hospital
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 585-8271
NPI assigned
Jan 4, 2007
Last updated
Oct 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAM BEAUMONT HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Authorized official

Name
Lesley Willbrandt
Title
Sr. Director Beaumont Shared SVCS
Phone
(947) 522-1911

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Psychologist 103T00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Hematology (Internal Medicine) Physician 207RH0000X NU
Hematology & Oncology Physician 207RH0003X NU
Infectious Disease Physician 207RI0200X NU
Nuclear Medicine Physician 207U00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Anatomic Pathology Physician 207ZP0101X NU
Psychiatry Physician 2084P0800X NU
Diagnostic Radiology Physician 2085R0202X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU
Hospitalist Physician 208M00000X NU Primary
Clinical Pathology Physician 207ZC0006X NU

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

26901 Beaumont Blvd
Compliance
Southfield, MI 48033-3849
Phone (947) 522-1964

Other identifiers 3

IdentifierTypeStateIssuer
0F364420OtherMIBCBSM
0F359270OtherMIBCBSM
0F349850OtherMIBCBSM

Other names 1

  • William Beaumont Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20031104000279 MI Part B Supplier - Clinic/Group Practice 9335051093 Receives reassigned benefits from 153 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Royal Oak, MI; West Bloomfield, MI; Warren, MI; Troy, MI; Sterling Heights, MI; St Clair Shores, MI; Southfield, MI; Shelby Township, MI…
O20040312000217 MI Part B Supplier - Clinic/Group Practice 9335051093 Receives reassigned benefits from 280 practitioners
Practice locations: Grosse Pointe, MI; Macomb, MI; Royal Oak, MI; Troy, MI; West Bloomfield, MI
O20040320000401 MI Part B Supplier - Clinic/Group Practice 1850282914 Receives reassigned benefits from 460 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20071107000096 MI Part A Provider - Hospital 9335051093 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Clair Shores, MI; Lenox, MI; Grosse Pointe, MI; Grosse Pointe Farms, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811044878. Details of each certification follow.

Hospital certification: CCN 230089

Legal name
WILLIAM BEAUMONT HOSPITAL
Doing business as
COREWELL HEALTH BEAUMONT GROSSE POINTE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 21, 2011
Beds
311
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

Care Compare: Hospital

Medicare Care Compare
Listed as
Beaumont Hospital - Grosse PointeCCN 230089 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
William Beaumont Hospital118 organizations share this tax ID, including this one
Part of
William Beaumont Hospital

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

16815 E Jefferson Ave
Grosse Pointe, MI 48230
Phone (313) 473-4690

21400 E 11 Mile Rd
St Clr Shores, MI 48081
Phone (586) 498-4400

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Whitney Eckhoff Individual W-2 Managing EmployeeManager, Provider Enrollment Oct 1, 2023
Robert Skandalaris Individual Corporate DirectorBoard Member Jan 1, 2025
Barbara J Pilarski Individual Corporate DirectorBoard Member Jan 1, 2024
Marija J Grahovac Individual Corporate DirectorBoard Member Jan 1, 2025
Chad M Tuttle Individual Corporate OfficerChief Operating Officer May 1, 2025 100%
Corporate DirectorBoard Member Jan 1, 2026
Mary Kosch Individual Corporate DirectorBoard Member Jan 1, 2026
Mona Makki Individual Corporate DirectorBoard Member Jan 1, 2023
Beaumont Health Organization, Southfield, MI Created for acquisition, Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2014 100%
Matthew E Cox Individual Corporate OfficerChief Financial Officer Feb 1, 2022 100%
Corewell Health Organization, Grand Rapids, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Feb 1, 2022 100%
Operational/Managerial Control Feb 1, 2022 100%
Lamont Yoder Individual Corporate DirectorBoard Member Jan 1, 2026
Robert James Welsh Individual Corporate DirectorBoard Member Jan 1, 2021
Warren E Rose Individual Corporate DirectorBoard Member Jan 1, 2022
Mark D Davidoff Individual Corporate DirectorBoard Member Jan 1, 2026
Nicholas P Gates Individual Corporate DirectorBoard Member Jan 1, 2026
Nancy Susick Individual Operational/Managerial ControlHospital President Nov 1, 2025 100%
Faye a Nelson Individual Corporate DirectorBoard Member Jun 16, 2022
Shane O'Donnell Individual Corporate DirectorBoard Member Jan 1, 2024
Anthony Stallion Individual Corporate DirectorBoard Member Feb 1, 2022
Linda Little Individual Corporate DirectorBoard Member Jun 16, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beaumont Home HealthTroy, MI, CCN 237112 Home health agency 5% Or Greater Indirect Ownership Interest (10%) Jan 1, 2019
Beaumont HospiceTroy, MI, CCN 231574 Hospice 5% Or Greater Indirect Ownership Interest (10%) Jan 1, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Beaumont Ashn, LLC

    dba Beaumont Home Health and Hospice, LLC

    • Home Health Agency
    • Troy, MI
    • NPI 1811461734

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Beaumont Ashn, LLC

    dba Beaumont Home Health and Hospice, LLC

    • Community Based Hospice Care Agency
    • Troy, MI
    • NPI 1851865786

    5% Or Greater Indirect Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 394

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 394

Affiliated clinicians 1,324

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,324

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1811044878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "address_2": "COMPLIANCE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-585-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BEAUMONT HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM BEAUMONT HOSPITAL",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "SR. DIRECTOR BEAUMONT SHARED SVCS",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F364420",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F359270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F349850",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "William Beaumont Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "William Beaumont Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.