NPIMap

Regents of the University of Michigan

Organization Active NPI Pediatrics Physician · Brighton, MI

NPI 1851682504 · NPPES record last updated Apr 30, 2021

Key facts

NPI
1851682504
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Practice address
8001 Challis Rd
Brighton, MI 48116-7446
Phone
(810) 227-9510
NPI assigned
Apr 29, 2011
Organization subpart
Yes
Parent organization (as reported)
REGENTS OF THE UNIVERSITY OF MICHIGAN

Authorized official

Name
David Christopher Miller, MD
Title
President
Phone
(734) 936-3568

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

  • Annissa Jabarin Hammoud, MD Internal Medicine Physician · Brighton, MI · NPI 1922197151
    NPD INTERNAL MEDICINE
  • Sandra L. Hearn, M.D. Physical Medicine & Rehabilitation Physician · Ann Arbor, MI · NPI 1952622813
    NPD
  • Robert Curtis Hyzy, MD Pulmonary Disease Physician · Ann Arbor, MI · NPI 1437231347
    NPD INTERNAL MEDICINE
  • Stacy Muallem, MD Internal Medicine Physician · Brighton, MI · NPI 1699399881
    NPD INTERNAL MEDICINE

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031106000325 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 2,340 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Regents of Univ of Michigan (157 organizations share this tax ID)
Part of
Regents of Univ of Michigan

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X MI
Adolescent Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RA0000X MI
Addiction Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RA0401X MI
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RM1200X MI
Sports Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RS0010X MI
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X MI Yes
Pediatric Clinical & Laboratory Immunology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080I0007X MI
Pediatric Neurodevelopmental Disabilities Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0008X MI
Pediatric Sports Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080S0010X MI
Pediatric Medical Toxicology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080T0002X MI
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208M00000X MI

Addresses

Primary practice location

8001 Challis Rd
Brighton, MI 48116-7446

Mailing address

3621 S State St
Provider Enrollment
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 30, 2021.

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1851682504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 CHALLIS RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481167446",
            "telephone_number": "810-227-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "enumeration_date": "2011-04-29",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-936-3568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "2080I0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Clinical & Laboratory Immunology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2080T0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Medical Toxicology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

All providers in Brighton, MI · Pediatrics Physician in Michigan

Sources for this page

Verify at the official NPI Registry.