Individual provider Active NPI

Bryan K Swilley, DO

  • General Practice Physician
  • Pontiac, MI
National Provider Identifier
1861409302
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5101010362 Issued in MI
Practice address
673 MLK Blvd N
Pontiac, MI 48342
Phone
(248) 338-2793
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101010362 MI Primary
Methadone Clinic 261QM2800X 5101010362 MI

Addresses

Primary practice location

673 MLK Blvd N
Pontiac, MI 48342

Mailing address

673 MLK Blvd N
Pontiac, MI 48342
Phone (248) 338-2793

Other identifiers 4

IdentifierTypeStateIssuer
132616OtherMICARE CHOICES
0856308604OtherMIBCBS
000000001401OtherMICAPE HEALTH PLAN
114402195MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101026000874 MI Practitioner - General Practice 6204028269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

673 Martin Luther King Jr Blvd N
Pontiac, MI 48342-1679
Phone (248) 338-2793

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BS010362MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perry MLK Medical Center P.C. General Practice CurrentSince Jul 1, 2002 Accepting new patients
Serenity Rehabilitation Center, Inc CurrentSince Oct 1, 2024 Accepting new patients
Hospital Health Care Inc. Family Medicine Past Accepting new patients

Locations

673 Mlk Blvd N
Pontiac, MI 48342
Phone (248) 334-0024

Organizations & group practices 3

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

Hospital & facility affiliations 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1861409302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 MLK BLVD N",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48342",
            "telephone_number": "248-338-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 MLK BLVD N",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48342",
            "telephone_number": "248-338-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWILLEY",
        "first_name": "BRYAN",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101010362",
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MI",
            "license": "5101010362",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "132616",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0856308604",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN",
            "identifier": "000000001401",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114402195",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.