Active NPI
Otto William Brown, MD
- Vascular Surgery Physician
- Bingham Farms, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 4301043496
- Practice address
- 31700 Telegraph Rd
Suite 140
Bingham Farms, MI 48025-3407 - Phone
- (248) 433-0881
- Fax
- (248) 433-1628
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 4301043496 | MI | Primary |
Addresses
Primary practice location
31700 Telegraph Rd
Suite 140
Bingham Farms, MI 48025-3407
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (248) 433-0881
Other practice location 1
6900 Orchard Lake Rd Ste 105
West Bloomfield, MI 48322-3424
Phone (248) 855-4190
Other practice location 2
1555 South Blvd E Ste 390
Rochester Hills, MI 48307-5624
Phone (248) 267-5005
Other practice location 3
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 551-4400
Other practice location 4
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-3839
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020002993 | Other | MI | MEDICARE RR |
| 2115358 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | obrown17345@direct.beaumont.edu |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Wayne State University School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28100 Grand River Ave
Farmington Hills, MI 48336-5970
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
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535
4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone (248) 655-3220
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Beaumont Hospital, Troy
- Beaumont Hospital - Farmington Hills
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients |
Locations
31700 Telegraph Rd
Ste 140
Bingham Farms, MI 48025
Phone (248) 433-0881
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
1555 South Blvd E
Ste 390
Rochester Hills, MI 48307
Phone (248) 267-5015
3601 W 13 Mile Rd
Royal Oak, MI 48073
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
Interoperability endpoints
- obrown17345@direct.beaumont.edu
Organizations & group practices 1
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1841308103",
"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",
"telephone_number": "248-433-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31700 TELEGRAPH RD",
"address_2": "SUITE 140",
"city": "BINGHAM FARMS",
"state": "MI",
"postal_code": "480253407",
"telephone_number": "248-433-0881",
"fax_number": "248-433-1628"
}
],
"practiceLocations": [
{
"address_1": "6900 Orchard Lake Rd Ste 105",
"address_purpose": "LOCATION",
"city": "West Bloomfield",
"state": "MI",
"postal_code": "483223424",
"country_code": "US",
"telephone_number": "248-855-4190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1555 South Blvd E Ste 390",
"address_purpose": "LOCATION",
"city": "Rochester Hills",
"state": "MI",
"postal_code": "483075624",
"country_code": "US",
"telephone_number": "248-267-5005",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-551-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-3839",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "OTTO",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MI",
"license": "4301043496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "020002993",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2115358",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "obrown17345@direct.beaumont.edu",
"affiliation": "N",
"address_1": "31700 Telegraph Rd",
"address_2": "Suite 140",
"city": "Bingham Farms",
"state": "MI",
"country_code": "US",
"postal_code": "480253407",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bingham Farms, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.