NPIMap

Organization Active NPI

Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
National Provider Identifier
1902842735
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
HENRY FORD MACOMB HOSPITAL CORPORATION
Practice address
13355 East 10 Mile Rd
Warren, MI 48089-2048
Phone
(313) 874-4633
Fax
(313) 847-3943
NPI assigned
Jun 21, 2006
Last updated
Jan 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Authorized official

Name
Mr. James M Connelly
Title
Sr. Vice President
Phone
(313) 874-8714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

13355 East 10 Mile Rd
Warren, MI 48089-2048

Mailing address

13355 E 10 Mile Rd
Warren, MI 48089-2048
Phone (313) 874-4633

Other identifiers 2

IdentifierTypeStateIssuer
230204OtherMIMEDICARE PTAN
1023114634MedicaidMI

Other names 1

  • Henry Ford Macomb Hospital- Warren Campus Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070711001016 MI Part A Provider - Hospital 7911808381 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Richmond, MI; Washington Township, MI; Washingtn TWP, MI; Mount Clemens, MI; Clinton TWP, MI; Clinton Township, MI; Chesterfield, MI; Bruce TWP, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902842735. Details of each certification follow.

Hospital certification: CCN 230047

Legal name
HENRY FORD MACOMB HOSPITAL CORPORATION
Doing business as
HENRY FORD HEALTH MACOMB HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 8, 2019
Beds
361
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Henry Ford Macomb HospitalCCN 230047 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 31

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daniel J. Phelan Individual Corporate Director Jan 1, 2022
Henry Ford Health System Organization, Troy, MI Corporation, Non-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 1966 100%
Charles McClure Individual Corporate Director Jul 25, 2014
Robert R Lubera Individual Corporate DirectorBoard Member Sep 1, 2025
Frederiek Toney Individual Corporate Director Jan 1, 2021
Barry G. Porter Individual Corporate Director Jan 1, 2020
Steven Brian Bender Individual Corporate OfficerSecretary Oct 21, 2024
Gerardo Norcia Individual Corporate Director Dec 1, 2023
Robert Riney Individual Corporate Director Jul 1, 2022
Michael Rafferty Individual Corporate Director Jan 1, 2020
Jeffrey Fall Individual Corporate DirectorBoard Member Sep 1, 2025
Farzan Siddiqui Individual Corporate Director Jan 1, 2024
Marjorie Staten Individual Corporate Officer Jan 1, 2019
Rhonda M Medows Individual Corporate DirectorBoard Member Sep 1, 2025
David Breen Individual Corporate Director Jan 1, 2015
Mary Ann Victor Individual Corporate DirectorBoard Member Sep 1, 2025
Jason Williams Individual W-2 Managing Employee Oct 1, 2024
Anthony Rocco Tersigni Individual Corporate Director Oct 1, 2024
Robin S. Damschroder Individual Corporate OfficerTreasurer Jan 1, 2018
Calvin R Ford Individual Corporate DirectorBoard Member Jan 1, 2025
Gregory Pflum Individual Corporate DirectorBoard Member Sep 1, 2025
Henry Ford Health Parent Organization, Detroit, MI Created for acquisition, Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024 80%
Edward D Callaghan Individual Corporate DirectorBoard Member Sep 1, 2025
John F. Harris Individual Corporate Director Jan 1, 2021
Ascension Health Organization, Saint Louis, MO Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024 20%
Edgar Vann Individual Corporate Director Jan 1, 2015
Lisa Fitzpatrick Individual Corporate DirectorBoard Member Jan 1, 2025
Joseph Richardson Individual Corporate Director Jan 1, 2016
Gwendolyn M Mackenzie Individual Corporate DirectorBoard Member Sep 1, 2025
Jacalyn S. Goforth Individual Corporate Director Jan 1, 2022
Eugene F Lovasco Individual Corporate Director Oct 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

Affiliated clinicians 1,429

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,429

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1902842735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13355 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "313-874-4633",
            "fax_number": "313-847-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 EAST 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "313-874-4633",
            "fax_number": "313-847-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD MACOMB HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "313-874-8714",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "230204",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023114634",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Macomb Hospital- Warren Campus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.