NPIMap

Individual provider Active NPI

Brilio Conrado Mojares, MD

  • Cardiovascular Disease Physician
  • Saint Clair Shores, MI
National Provider Identifier
1952350126
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301071984 Issued in MI
Practice address
24211 Little Mack Ave
St Clair Shores, MI 48080-1190
Phone
(586) 498-0440
Fax
(586) 498-0401
NPI assigned
May 8, 2006
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301071984 MI Primary

Addresses

Primary practice location

24211 Little Mack Ave
St Clair Shores, MI 48080-1190

Mailing address

24211 Little Mack Ave
St Clair Shores, MI 48080-1190
Phone (586) 498-0440

Other identifiers 2

IdentifierTypeStateIssuer
4716615MedicaidMI
10OtherMI10

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bmojares31634@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411000704 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9234176330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastlake Cardiovascular PCGroup PAC ID 4688562176, 22 clinicians

Practice addresses (Care Compare)

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5000

24211 Little Mack Ave
Saint Clair Shores, MI 48080-1151
Phone (810) 498-0440

27351 Dequindre Rd
Madison Heights, MI 48071-3487
Phone (248) 967-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.31 of 100Reported as group
Quality
66.77
Promoting interoperability
100
Improvement activities
40
Cost
76.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2005 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2005 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Cardiovascular Disease CurrentSince Oct 9, 2010 Accepting new patients
Eastlake Cardiovascular PC Cardiovascular Disease CurrentSince Jul 18, 2005 Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

27483 Dequindre Rd
Ste 210
Madison Heights, MI 48071
Phone (248) 398-0964

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

24211 Little Mack Ave
St Clr Shores, MI 48080
Phone (586) 498-0440

Interoperability endpoints

  • Direct secure messaging: bmojares31634@direct.beaumont.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1952350126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24211 LITTLE MACK AVE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801190",
            "telephone_number": "586-498-0440",
            "fax_number": "586-498-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24211 LITTLE MACK AVE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801190",
            "telephone_number": "586-498-0440",
            "fax_number": "586-498-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJARES",
        "first_name": "BRILIO",
        "middle_name": "CONRADO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301071984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4716615",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "10",
            "identifier": "10",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmojares31634@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "24211 Little Mack Ave",
            "city": "St Clair Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480801190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.