NPIMap

Organization Active NPI

MMG 1PC

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1881714723
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MMG 1PC
Practice address
28000 Joy Rd
Livonia, MI 48150-4137
Phone
(734) 513-8050
Fax
(734) 513-6357
NPI assigned
Mar 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Mr. Alex A Torres
Title
Billing Manager
Phone
(703) 684-4581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

28000 Joy Rd
Livonia, MI 48150-4137

Mailing address

29992 Northwestern Hwy Ste C
Farmington Hills, MI 48334-3292
Phone (248) 851-1430

Other identifiers 3

IdentifierTypeStateIssuer
110163653OtherGARAILROAD MEDICARE
343393810MedicaidMI
700F314390OtherMIBCBS MI

National Provider Directory

National Provider Directory
Tax ID family
MMG 1PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1881714723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28000 JOY RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481504137",
            "telephone_number": "734-513-8050",
            "fax_number": "734-513-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG 1PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "703-684-4581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110163653",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343393810",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "700F314390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.