Individual provider Active NPI

Adam Michael Maciver, NP

  • Nurse Practitioner
  • Monroe, MI
National Provider Identifier
1821439779
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704276022 Issued in MI
Practice address
321 Stewart Rd
Monroe, MI 48162-4393
Phone
(734) 243-5020
Fax
(734) 457-1970
NPI assigned
Jul 8, 2013
Last updated
Jun 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704276022 MI Primary

Addresses

Primary practice location

321 Stewart Rd
Monroe, MI 48162-4393

Mailing address

321 Stewart Rd
Monroe, MI 48162-4393
Phone (734) 243-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131011001122 MI Practitioner - Nurse Practitioner 7012141799 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704276022MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Ear, Nose and Throat Associates, P.C. CurrentSince May 18, 2019 Accepting new patients
Ryan Meredith, Au.D., P.C. PastSince May 18, 2019 Accepting new patients

Locations

321 Stewart Rd
Monroe, MI 48162
Phone (734) 243-5020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1821439779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624393",
            "telephone_number": "734-243-5020",
            "fax_number": "734-457-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624393",
            "telephone_number": "734-243-5020",
            "fax_number": "734-457-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIVER",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704276022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.