Macomb Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MACOMB MEDICAL CLINIC PC

Practice address

2405 E 14 Mile Rd
Sterling Heights, MI 48310-5961

Phone

(586) 264-1800

Fax

(586) 264-1155

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Mark Stephen Rosenberg, DONPI 1184601510

Title

Director

Phone

(586) 264-1800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Stephen Rosenberg, DO

  • Family Medicine Physician
  • Sterling Heights, MI
  • NPI 1184601510
  Medicare reassignment Authorized official
• David Giancola III, P.A.

  • Physician Assistant
  • Sterling Heights, MI
  • NPI 1013466705
  Medicare reassignment
• Amar Kurjakovic, PA-C

  • Physician Assistant
  • Sterling Heights, MI
  • NPI 1518746031
  Medicare reassignment
• Jillian Monticciolo, PA-C

  • Physician Assistant
  • Sterling HTS, MI
  • NPI 1861949950
  Medicare reassignment
• Brooke L. Tobia, PA-C

  • Medical Physician Assistant
  • Sterling Heights, MI
  • NPI 1568740918
  Medicare reassignment

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1922120070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 E 14 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105961",
            "telephone_number": "586-264-1800",
            "fax_number": "586-264-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 E 14 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105961",
            "telephone_number": "586-264-1800",
            "fax_number": "586-264-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-264-1800",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macomb County Community Health
• Macomb County Community Mental Health
• Macomb Dental Group PLLC
• Macomb Emergency Dental Clinic PC
• Macomb Infectious Disease Specialists PLLC
• Macomb Pharmacy, Inc.
• Macomb Physicians Group, PLLC
• Macomb Rehab Methods
• Macomb Vision Clinic, Inc.
• Gary Ray Macon, D.C.

• Family Medicine Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.