Individual provider Active NPI

Nicola M Colucci, DO

  • Emergency Medicine Physician
  • Clinton Township, MI
National Provider Identifier
1841827599
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5151014321 Issued in MI
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2953
NPI assigned
Mar 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 5151014321 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ncolucci529916@direct.hfhs.org

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
I20230921001289 MI Practitioner - Emergency Medicine 9335561141 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Observation Physicians PLLCGroup PAC ID 3577603604, 138 clinicians
Independent Emergency Physicians PCGroup PAC ID 6709798325, 173 clinicians

Practice addresses (Care Compare)

1101 W University Dr
Rochester, MI 48307-1863
Phone (248) 652-5000

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2601

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3331

47601 Grand River Ave
Novi, MI 48374-1233
Phone (248) 465-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Emergency Physicians, P.C. CurrentSince Jan 15, 2026 Accepting new patients
Professional Emergency Care, PC Emergency Medicine CurrentSince Aug 21, 2023 Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1841827599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLUCCI",
        "first_name": "NICOLA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151014321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncolucci529916@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.