Active NPI
Mena Misiak
- Family Medicine Physician
- West Bloomfield, MI
National Provider Identifier
1871295261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301516935
- Practice address
- 6530 Farmington Rd
West Bloomfield, MI 48322-3216 - Phone
- (248) 661-4100
- NPI assigned
- Mar 20, 2023
- Last updated
- Jul 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 4301516935 | MI | Primary |
Addresses
Primary practice location
6530 Farmington Rd
West Bloomfield, MI 48322-3216
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230914000776 | MI | Order and Referring Only - Family Practice | 1658735378 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oakland Univ, William Beaumont School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Ford PL
Detroit, MI 48202-3067
1 Ford PL
3A
Detroit, MI 48202-3450
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- mmisiak2736278@direct.trinity-health.org
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brighton, MI
- NPI 1093748642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1871295261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "313-874-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6530 FARMINGTON RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223216",
"telephone_number": "248-661-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISIAK",
"first_name": "MENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301516935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.