Organization Active NPI

Novus Primary Care, PLLC

  • Family Medicine Physician
  • Berkley, MI
National Provider Identifier
1861159600
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NOVUS PRIMARY CARE, PLLC
Practice address
3211 Coolidge Hwy
Berkley, MI 48072-1633
Phone
(248) 514-3397
NPI assigned
Nov 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Authorized official

Name
Alexandra Lee Pierret, MDNPI 1376925131
Title
Owner/Physician
Phone
(248) 514-3397

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

3211 Coolidge Hwy
Berkley, MI 48072-1633

Mailing address

3707 Linwood Ave
Royal Oak, MI 48073-2355
Phone (248) 514-3397

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220502001242 MI Part B Supplier - Clinic/Group Practice 9739576208 Receives reassigned benefits from 1 practitioner
Practice locations: Berkley, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2250907Novus Primary Care3211 Coolidge Highway, Berkley, MI 48072Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1861159600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 LINWOOD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732355",
            "telephone_number": "248-514-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721633",
            "telephone_number": "248-514-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVUS PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "PIERRET",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "248-514-3397",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.