NPIMap

Individual provider Active NPI

Philip Riley

  • Family Medicine Physician
  • Rochester, MI
National Provider Identifier
1851820518
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301501699 Issued in MI
Practice address
1101 W University Dr # 2-South
Rochester, MI 48307-1863
Phone
(248) 601-4900
NPI assigned
Jun 7, 2017
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 NU
Family Medicine Physician 207Q00000X 4301501699 MI Primary

Addresses

Primary practice location

1101 W University Dr # 2-South
Rochester, MI 48307-1863

Mailing address

750 Willard Ave
Rochester Hills, MI 48307-2362

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address priley682643@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504001690 MI Practitioner - Family Practice 0042641201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

153 Wampiers Lake Rd
Henry Ford Allegiance Family Medicine Brook
Brooklyn, MI 49230-9585
Phone (517) 205-2105

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 30, 2020 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Wa Foote Memorial Hospital Inc Family Medicine CurrentSince Apr 30, 2020 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

153 Wamplers Lake Rd
Brooklyn, MI 49230
Phone (517) 205-2105

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Interoperability endpoints

  • Direct secure messaging: priley682643@direct.hfhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1851820518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WILLARD AVE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY DR # 2-SOUTH",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071863",
            "telephone_number": "248-601-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "PHILIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301501699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "priley682643@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "153 Wamplers Lake Rd",
            "city": "Brooklyn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492309585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.