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Individual provider Active NPI

Rojin Edward Callo Teodoro, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Livonia, MI
National Provider Identifier
1831714278
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009838 Issued in MI
Practice address
18312 Middlebelt Rd
Livonia, MI 48152-5007
Phone
(248) 680-9000
NPI assigned
Jun 11, 2020
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009838 MI Primary

Addresses

Primary practice location

18312 Middlebelt Rd
Livonia, MI 48152-5007

Mailing address

8291 Marian St
Warren, MI 48093-2766
Phone (586) 960-4029

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
I20200804000408 MI Practitioner - Physician Assistant 8022433317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Sports and Spine Center PCGroup PAC ID 0749243467, 5 clinicians
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

1819 E Big Beaver Rd
Suite 210
Troy, MI 48083-2015
Phone (248) 680-9000

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.84 of 100Reported as group
Quality
85.89
Promoting interoperability
0
Improvement activities
40
Cost
66.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Total Extended Care Services PC CurrentSince Dec 10, 2025 Accepting new patients

Locations

725 Fuller Ave
Big Rapids, MI 49307
Phone (231) 796-2631

4001 Walli Strasse Dr
Ste A
Burton, MI 48509
Phone (810) 715-7746

400 Jeffrey St
Cedar Springs, MI 49319
Phone (616) 696-0170

3400 Wilson Ave SW
Grandville, MI 49418
Phone (616) 534-5487

18312 Middlebelt Rd
Livonia, MI 48152
Phone (248) 426-9944

25375 Kelly Rd
Roseville, MI 48066
Phone (586) 733-6022

6950 Farmington Rd
West Bloomfield, MI 48322
Phone (248) 478-5645

28 S Prospect St
Ypsilanti, MI 48198
Phone (734) 483-2220

Organizations & group practices 3

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 10

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1831714278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8291 MARIAN ST",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932766",
            "telephone_number": "586-960-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18312 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481525007",
            "telephone_number": "248-680-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEODORO",
        "first_name": "ROJIN EDWARD",
        "middle_name": "CALLO",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.