Individual provider Active NPI

Mark P. Selitsky, M.D.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1831267368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50678 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2600
Fax
(313) 916-3235
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50678 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000164 MI Practitioner - Internal Medicine 7315075512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-6688

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50678MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jan 1, 1975 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince Jan 1, 1975 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1961 S Telegraph Rd
Bloomfield Township, MI 48302
Phone (248) 319-6190

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

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

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

Interoperability endpoints

  • Direct secure messaging: mselitsky12820@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831267368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600",
            "fax_number": "313-916-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELITSKY",
        "first_name": "MARK",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "50678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.