Active NPI
Alison Marie Premo, M.D.
- Anesthesiology Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301097666
- Practice address
- 2799 West Grand BLD.
4TH Floor
Detroit, MI 48202 - Phone
- (866) 600-2273
- NPI assigned
- Jun 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301097666 | MI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | 125050142 | IL |
Addresses
Primary practice location
2799 West Grand BLD.
4TH Floor
Detroit, MI 48202
Mailing address
715 N Old Woodward Ave
Birmingham, MI 48009-1320
Phone (773) 621-3027
Other names 1
- Mrs. Alison Marie Simmons
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Wayne State University School of Medicine, 2005
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (214) 687-0001
Hospital & facility affiliations
- Beaumont Hospital - Dearborn
- Corewell Health Wayne Hospital
- Beaumont Hospital - Taylor
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125050142 | IL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Michigan III PLLC | Current | Accepting new patients | |
| St Joseph Mercy Hospital | Past | Accepting new patients | |
| Balanced Being Psychotherapy PLLC | Past | Accepting new patients |
Locations
18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI
-
- Clinical Social Worker
- Ann Arbor, MI
- NPI 1326804923
-
- Cardiac Rehabilitation Clinic/Center
- Ypsilanti, MI
- NPI 1902359094
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wayne, MI
- NPI 1295785285
-
- General Acute Care Hospital
- Taylor, MI
- NPI 1487605168
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292284800000",
"number": "1972706596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 N OLD WOODWARD AVE",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480091320",
"telephone_number": "773-621-3027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 WEST GRAND BLD.",
"address_2": "4TH FLOOR",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "866-600-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREMO",
"first_name": "ALISON",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-10",
"last_updated": "2010-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301097666",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "125050142",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALISON",
"last_name": "SIMMONS",
"middle_name": "MARIE",
"prefix": "MRS.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.