NPIMap

Organization Active NPI

North Oakland ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Waterford, MI
National Provider Identifier
1942393475
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
636823 Issued in MI
Legal business name
NORTH OAKLAND ASC LLC
Practice address
1305 North Oakland Blvd
Waterford, MI 48327-1547
Phone
(248) 666-5552
Fax
(248) 666-5549
NPI assigned
Oct 2, 2006
Organization subpart
Yes
Parent organization
OAKLAND PHYSICIANS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Michael L Derubeis
Title
Cfo
Phone
(248) 857-7583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 636823 MI Primary

Addresses

Primary practice location

1305 North Oakland Blvd
Waterford, MI 48327-1547

Mailing address

461 West Huron St
Suite 206
Pontiac, MI 48341-0000
Phone (248) 857-7583

Other identifiers 5

IdentifierTypeStateIssuer
141676OtherMICARE CHOICES
17412OtherMIMCARE
40347OtherMIBCBS - FACILITY
490F32891OtherMIBCBS - PROFESSIONAL
B0100OtherMIBCN

National Provider Directory

National Provider Directory
Part of
Oakland Physician Med LLC

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1942393475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 WEST HURON ST",
            "address_2": "SUITE 206",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483410000",
            "telephone_number": "248-857-7583",
            "fax_number": "248-857-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 NORTH OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271547",
            "telephone_number": "248-666-5552",
            "fax_number": "248-666-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH OAKLAND ASC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLAND PHYSICIANS MEDICAL CENTER",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "DERUBEIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "248-857-7583"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "636823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "141676",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "17412",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - FACILITY",
            "identifier": "40347",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - PROFESSIONAL",
            "identifier": "490F32891",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "B0100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.