Active NPI
Regional Trauma Care PC
- Surgery Physician
- Mount Clemens, MI
National Provider Identifier
1851554497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mandip Atwal, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryPractitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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.