NPIMap

Organization Active NPI

Regional Trauma Care PC

  • Surgery Physician
  • Mount Clemens, MI
National Provider Identifier
1851554497
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
REGIONAL TRAUMA CARE PC
Practice address
1000 Harrington St
Trauma Services
Mount Clemens, MI 48043-2920
Phone
(586) 493-3814
Fax
(586) 493-2029
NPI assigned
Jul 3, 2008
Last updated
Oct 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Mr. Mandip Atwal, MDNPI 1972573061
Title
Manager
Phone
(248) 543-8070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1000 Harrington St
Trauma Services
Mount Clemens, MI 48043-2920

Mailing address

PO Box 44047
Detroit, MI 48244-0047
Phone (248) 543-8070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081009000458 MI Part B Supplier - Clinic/Group Practice 3173691771 Receives reassigned benefits from 10 practitioners
Practice locations: Mount Clemens, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1851554497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44047",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482440047",
            "telephone_number": "248-543-8070",
            "fax_number": "248-543-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "address_2": "TRAUMA SERVICES",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-3814",
            "fax_number": "586-493-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL TRAUMA CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "ATWAL",
        "authorized_official_first_name": "MANDIP",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-543-8070",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.