NPIMap

Organization Active NPI

Metropolitan Medical Center PLLC

  • Internal Medicine Physician
  • Hamtramck, MI
National Provider Identifier
1922193960
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301063858 Issued in MI
Legal business name
METROPOLITAN MEDICAL CENTER PLLC
Practice address
9230 Joseph Campau St
Hamtramck, MI 48212-3731
Phone
(313) 875-9270
Fax
(313) 875-9420
NPI assigned
Oct 4, 2006
Last updated
Nov 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
Matthew Wietrzykowski, MDNPI 1528040979
Title
Owner President
Phone
(313) 875-9270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301063858 MI Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 4301081423 MI

Addresses

Primary practice location

9230 Joseph Campau St
Hamtramck, MI 48212-3731

Mailing address

9230 Joseph Campau St
Hamtramck, MI 48212-3731
Phone (313) 875-9270

Other identifiers 13

IdentifierTypeStateIssuer
110H241220OtherMIBCBS GROUP
110H241220OtherMIBCN GROUP
151659OtherMIGREAT LAKES HEALTH CARE
1922193960MedicaidMI
022808OtherMIMIDWEST HEALTH PLAN
35949OtherMIHEALTH PLAN OF MICHIGAN
5458769OtherMIAETNA
000000001426OtherMICAPE HEALTH PLAN
DO5413OtherMIRAILROAD MEDICARE
1108269932OtherMIBCBS OF MICHIGAN
C6560OtherMIMCARE
G76852OtherMIHAP
104391529MedicaidMI

National Provider Directory

National Provider Directory

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1922193960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9230 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123731",
            "telephone_number": "313-875-9270",
            "fax_number": "313-875-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9230 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123731",
            "telephone_number": "313-875-9270",
            "fax_number": "313-875-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "WIETRZYKOWSKI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "313-875-9270",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301063858",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301081423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "110H241220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "110H241220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH CARE",
            "identifier": "151659",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922193960",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "022808",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN",
            "identifier": "35949",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5458769",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN",
            "identifier": "000000001426",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DO5413",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "1108269932",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C6560",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "G76852",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104391529",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamtramck, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.