Michigan Mobile Medicine, PLLC

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

Legal business name

MICHIGAN MOBILE MEDICINE, PLLC

Practice address

43700 Woodward Ave Ste 207
Bloomfield Hills, MI 48302-5061

Phone

(248) 481-2100

Fax

(248) 359-8750

NPI assigned

Sep 28, 2024

Organization subpart

No

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

Authorized official

Name

Diego A Hernandez, MDNPI 1356360143

Title

Medical Director

Phone

(248) 481-2100

Specialties & licenses 1

Addresses

Other names 1

• Michigan Mobile Medicine, PLLC Former legal business name

Practitioners 3

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

• Diego Hernandez, M.D.

  • Vascular Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1356360143
  NPD Authorized official
• Jessica Long, NP

  • Nurse Practitioner
  • Shelby TWP, MI
  • NPI 1922519958
  NPD
• Natalie Gabrielle Marcus, FNP-BC

  • Family Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1730603903
  NPD

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

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727481600000",
    "number": "1962220053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43700 WOODWARD AVE STE 207",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025061",
            "telephone_number": "248-481-2100",
            "fax_number": "248-359-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43700 WOODWARD AVE STE 207",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025061",
            "telephone_number": "248-481-2100",
            "fax_number": "248-359-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MOBILE MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-481-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Mobile Medicine, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Michigan Digestive Associates PC
• Michigan Expert Care and Staffing LLC
• Michigan Institute of Performance and Health
• Michigan Internal Medicine Center PC
• Michigan Light Therapy PC
• Michigan Paratransit Services, LLC
• Michigan Psychological & Consulting Services PC
• Michigan Reproductive Medicine
• Michigan Sleep Wellness, PLLC
• Micki Levin JD PHD

• Wound Care Registered Nurse in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Wound Care Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2024; 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.