Individual provider Active NPI

Sherwin P Imlay, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Pontiac, MI
National Provider Identifier
1922035799
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
073491 Issued in MI
Practice address
44405 Woodward Ave
St. Joseph Mercy Hospital
Pontiac, MI 48341-2985
Phone
(248) 858-3190
Fax
(248) 858-3148
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 073491 MI Primary

Addresses

Primary practice location

44405 Woodward Ave
St. Joseph Mercy Hospital
Pontiac, MI 48341-2985

Mailing address

PO Box 55-114
Detroit, MI 48255-0001
Phone (248) 858-3197

Other identifiers 2

IdentifierTypeStateIssuer
4093859MedicaidMI
220024626OtherMIRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000453 MI Practitioner - Pathology 7911926498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Missouri, Columbia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Pathology Consultants PCGroup PAC ID 3678502671, 5 clinicians

Practice addresses (Care Compare)

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-3190

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Merit-based Incentive Payment System (MIPS)

Final score
82.5 of 100Reported as group
Quality
65
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073491MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Mercy Hospital Crna Group Current Accepting new patients
Northwest Pathology Consultants PC Anatomic Pathology & Clinical Pathology PastSince Dec 18, 2022 Accepting new patients

Locations

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1922035799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55-114",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482550001",
            "telephone_number": "248-858-3197",
            "fax_number": "248-858-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "address_2": "ST. JOSEPH MERCY HOSPITAL",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412985",
            "telephone_number": "248-858-3190",
            "fax_number": "248-858-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMLAY",
        "first_name": "SHERWIN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "073491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4093859",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "220024626",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.