Individual provider Active NPI

Mark Lawrence Silverman, M.D.

  • Psychiatry Physician
  • Birmingham, MI
National Provider Identifier
1972620854
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301055165 Issued in MI
Practice address
1019 Haynes St
Birmingham, MI 48009-6779
Phone
(248) 647-0391
Fax
(248) 647-9142
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301055165 MI Primary
Child & Adolescent Psychiatry Physician 2084P0804X 4301055165 MI

Addresses

Primary practice location

1019 Haynes St
Birmingham, MI 48009-6779

Mailing address

1019 Haynes St
Birmingham, MI 48009-6779
Phone (248) 647-0391

Other identifiers 2

IdentifierTypeStateIssuer
172714OtherMICOMPSYCH PROVIDER #
38-3309235OtherTAX ID #

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
I20070810000239 MI Practitioner - Psychiatry 8820189459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Cincinnati College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1019 Haynes St
Birmingham, MI 48009-6779
Phone (248) 647-0391

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301055165MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imagine Health, P.C. Psychiatry CurrentSince Apr 30, 2003 Accepting new patients

Locations

1019 Haynes St
Birmingham, MI 48009
Phone (248) 647-0391

401 S Old Woodward Ave
Ste 4
Birmingham, MI 48009
Phone (248) 647-0391

Organizations & group practices 1

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1972620854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 HAYNES ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096779",
            "telephone_number": "248-647-0391",
            "fax_number": "248-647-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 HAYNES ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096779",
            "telephone_number": "248-647-0391",
            "fax_number": "248-647-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVERMAN",
        "first_name": "MARK",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301055165",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301055165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH PROVIDER #",
            "identifier": "172714",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "38-3309235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

Verify at the official NPI Registry.