Active NPI
Michigan Family Medicine, PLLC
- Family Medicine Physician
- Sylvan Lake, MI
National Provider Identifier
1912710609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MICHIGAN FAMILY MEDICINE, PLLC
- Practice address
- 2167 Orchard Lake Road
Suite-B
Sylvan Lake, MI 48320 - Phone
- (248) 857-7878
- Fax
- (248) 857-7888
- NPI assigned
- Jan 28, 2025
- Last updated
- Mar 19, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Nazma Khan Amin
- Title
- Office Manager
- Phone
- (248) 857-7878
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
2167 Orchard Lake Road
Suite-B
Sylvan Lake, MI 48320
Mailing address
2167 Orchard Lake Road
Suite-B
Sylvan Lake, MI 48320
Phone (248) 857-7878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 803248117 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Michigan Family Medicine
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Michigan Family Medicine
- Family Medicine Physician
- Sylvan Lake, MI
- NPI 1952106825
Locations
2167 Orchard Lake Rd
Sylvan Lake, MI 48320
Practitioners & affiliated clinicians
Practitioners 1
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": "1738022400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742342400000",
"number": "1912710609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2167 ORCHARD LAKE ROAD",
"address_2": "SUITE-B",
"city": "SYLVAN LAKE",
"state": "MI",
"postal_code": "48320",
"telephone_number": "248-857-7878",
"fax_number": "248-857-7888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2167 ORCHARD LAKE ROAD",
"address_2": "SUITE-B",
"city": "SYLVAN LAKE",
"state": "MI",
"postal_code": "48320",
"telephone_number": "248-857-7878",
"fax_number": "248-857-7888"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHIGAN FAMILY MEDICINE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-28",
"last_updated": "2025-03-19",
"status": "A",
"authorized_official_last_name": "AMIN",
"authorized_official_first_name": "NAZMA",
"authorized_official_middle_name": "KHAN",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "248-857-7878",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "803248117",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sylvan Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.