NPIMap

Individual provider Active NPI

Marc Brodsky, MD

  • Cardiovascular Disease Physician
  • W Bloomfield, MI
National Provider Identifier
1821024647
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MB047506 Issued in MI
Practice address
6900 Orchard Lake Rd Ste 106
W Bloomfield, MI 48322-3424
Phone
(248) 788-4278
Fax
(248) 788-2001
NPI assigned
Jun 23, 2006
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MB047506 MI Primary

Addresses

Primary practice location

6900 Orchard Lake Rd Ste 106
W Bloomfield, MI 48322-3424

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other identifiers 1

IdentifierTypeStateIssuer
4162590MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbrodsky20025@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080102000229 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5991885006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Michigan Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8000

28100 Grand River Ave
Farmington Hills, MI 48336-5970

29645 W 14 Mile Rd
200 Beaumont Cardiovascular Specialists
Farmington Hills, MI 48334-1666
Phone (248) 932-3700

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

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058

39000 7 Mile Rd
Livonia, MI 48152-1006
Phone (947) 523-4410

44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-0400

4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone (248) 655-3220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MB047506MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Mar 13, 2018 Accepting new patients
Henry Ford Health System CurrentSince Aug 1, 2012 Accepting new patients
Henry Ford Health System Cardiovascular Disease CurrentSince Aug 1, 2012 Accepting new patients
William Beaumont Hospital Past Accepting new patients
Bruce Millman, D.O., PLLC PastSince Nov 1, 1999 Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3601 W 13 Mile Rd
Royal Oak, MI 48073

4949 Coolidge Hwy
Royal Oak, MI 48073
Phone (248) 655-5660

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: mbrodsky1226844@epic00.shdirect.org
  • Direct secure messaging: mbrodsky20025@direct.beaumont.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1821024647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD STE 106",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223424",
            "telephone_number": "248-788-4278",
            "fax_number": "248-788-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "MB047506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4162590",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrodsky20025@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "6900 Orchard Lake Rd Ste 106",
            "city": "W Bloomfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483223424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in W Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.