Individual provider Active NPI

Alexander Peter Bill, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Saint Clair Shores, MI
National Provider Identifier
1932549375
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
5101020625 Issued in MI
Practice address
22631 Greater Mack Ave Ste 200
Saint Clair Shores, MI 48080
Phone
(586) 773-6900
NPI assigned
Jun 30, 2013
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101020625 MI Primary

Addresses

Primary practice location

22631 Greater Mack Ave Ste 200
Saint Clair Shores, MI 48080

Mailing address

309 Northbound Gratiot Ave
Mount Clemens, MI 48043-5748
Phone (586) 463-5831

Other practice location 1

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (586) 493-8000

Other practice location 2

309 Northbound Gratiot Ave
Mount Clemens, MI 48043-5748
Phone (586) 463-5831

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
I20180618002432 MI Practitioner - Otolaryngology 9436470598 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020625MIMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pointes Plastic Surgery Associates P C CurrentSince Oct 31, 2018 Accepting new patients
Michael Sherbin DO PC CurrentSince Jul 1, 2018 Accepting new patients

Locations

309 Northbound Gratiot Ave
Mount Clemens, MI 48043
Phone (586) 463-5831

22631 Greater Mack Ave
Ste 200
St Clr Shores, MI 48080
Phone (313) 886-8900

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1932549375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 NORTHBOUND GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435748",
            "telephone_number": "586-463-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22631 GREATER MACK AVE STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-773-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Harrington St",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480432920",
            "country_code": "US",
            "telephone_number": "586-493-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Northbound Gratiot Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480435748",
            "country_code": "US",
            "telephone_number": "586-463-5831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILL",
        "first_name": "ALEXANDER",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-30",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101020625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.