MMG 1 PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MMG 1 PC

Doing business as

Millenium Diagnostic Center

Practice address

32255 Northwestern Hwy Ste 100
Farmington Hills, MI 48334-1573

Phone

(248) 945-0000

Fax

(248) 945-1819

NPI assigned

Jun 24, 2006

Last updated

Dec 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Geoffrey A. Trivax, M.D.

Title

President

Phone

(248) 851-1430

Specialties & licenses 11

Addresses

Other names 1

• MILLENIUM DIAGNOSTIC CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 9

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

• MMG 1 PC

  • Nurse Practitioner
  • Southfield, MI
  • NPI 1023037025

  O20031104000106

  Same enrollment
• MMG 1 PC

  dba Internal Medicine Specialists

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1023043486

  O20031104000106

  Same enrollment
• MMG 1 PC

  dba Internal Medicine Physicians

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1982639357

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Comprehensive Internists

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1073548442

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Internal Medicine Plus

  • Internal Medicine Physician
  • Bingham Farms, MI
  • NPI 1154356517

  O20031104000106

  Same enrollment
• MMG 1PC

  • Family Medicine Physician
  • West Bloomfield, MI
  • NPI 1205855186

  O20031104000106

  Same enrollment
• MMG 1PC

  • Internal Medicine Physician
  • Bingham Farms, MI
  • NPI 1225063688

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Associated Rheumatology Consultants

  • Rheumatology Physician
  • Southfield, MI
  • NPI 1629184049

  O20031104000106

  Same enrollment
• MMG 1PC

  dba Premier Internists

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1679586192

  O20031104000106

  Same enrollment

Locations

Practitioners 30

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.

• Syed Jafri, MD

  • Diagnostic Radiology Physician
  • Royal Oak, MI
  • NPI 1467412221
  Medicare reassignment Care Compare group NPD
• James Lyddon, DO

  • Diagnostic Radiology Physician
  • Farmington Hills, MI
  • NPI 1992770986
  Medicare reassignment Care Compare group NPD
• Anindya Roy, MD

  • Diagnostic Radiology Physician
  • Royal Oak, MI
  • NPI 1083674071
  Medicare reassignment Care Compare group NPD
• Christopher S Sweet, M.D.

  • Diagnostic Radiology Physician
  • Lansing, MI
  • NPI 1871533067
  Medicare reassignment Care Compare group NPD
• Justin Elijah Trivax, M.D.

  • Cardiovascular Disease Physician
  • Bingham Farms, MI
  • NPI 1174566095

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Daya Vora, M.D.

  • Diagnostic Radiology Physician
  • Farmington Hills, MI
  • NPI 1023218153
  Medicare reassignment Care Compare group NPD
• Matthew Joseph Kovie, D.O.

  • Diagnostic Radiology Physician
  • Garden City, MI
  • NPI 1497961353
  Medicare reassignment Care Compare group
• Charles T. Cash III, M.D.

  • Vascular & Interventional Radiology Physician
  • Dearborn, MI
  • NPI 1265631733
  Medicare reassignment NPD
• George Rami Dirani, M.D

  • Cardiovascular Disease Physician
  • Farmington Hills, MI
  • NPI 1619310885

  Internal Medicine

  Medicare reassignment NPD
• Dustin Blake Feldman, D.O.

  • Cardiovascular Disease Physician
  • Farmington Hills, MI
  • NPI 1689894867

  Internal Medicine

  Medicare reassignment NPD
• Stephen Jerome Gunther, MD

  • Cardiovascular Disease Physician
  • Southfield, MI
  • NPI 1205942182
  Medicare reassignment NPD
• Michael Fredrick Haenick, MD

  • Physical Medicine & Rehabilitation Physician
  • Novi, MI
  • NPI 1235127770
  Medicare reassignment NPD

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1912933540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY",
            "address_2": "SUITE 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": "32255 NORTHWESTERN HWY STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341573",
            "telephone_number": "248-945-0000",
            "fax_number": "248-945-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG 1 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "TRIVAX",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-851-1430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLENIUM DIAGNOSTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Vincent Mizzi, DO
• Howa Mkoma
• Mohamed Mkoma
• Sarafina Mmbaga
• MMG 1 PC (Millennium Diagnostic Center)
• MMG 1 PC (Internal Medicine Physicians)
• Solace Mngo
• Peter Moa
• Shelbi Moats
• Mobile Dentists Military Management

• Internal Medicine Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.