Organization Active NPI

Addison Community Physician Services Association

  • Diagnostic Radiology Physician
  • Ypsilanti, MI
National Provider Identifier
1912066093
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADDISON COMMUNITY PHYSICIAN SERVICES ASSOCIATION
Practice address
135 S Prospect St
Ypsilanti, MI 48198-7914
Phone
(734) 547-4900
Fax
(734) 547-1161
NPI assigned
Dec 6, 2006
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Joann K Scripko
Title
Patient Accounts Manager
Phone
(734) 547-1174

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

135 S Prospect St
Ypsilanti, MI 48198-7914

Mailing address

135 S Prospect St
Ypsilanti, MI 48198-7914
Phone (734) 547-4900

Other identifiers 1

IdentifierTypeStateIssuer
700H111110OtherMIBCBS OF MI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060412000082 MI Part B Supplier - Clinic/Group Practice 3779592217 Receives reassigned benefits from 1 practitioner
Practice locations: Ypsilanti, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1912066093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S PROSPECT ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987914",
            "telephone_number": "734-547-4900",
            "fax_number": "734-547-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S PROSPECT ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987914",
            "telephone_number": "734-547-4900",
            "fax_number": "734-547-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDISON COMMUNITY PHYSICIAN SERVICES ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "SCRIPKO",
        "authorized_official_first_name": "JOANN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PATIENT ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "734-547-1174"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "700H111110",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.