Michigan Orthopaedic Spine Surgeons PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301051364 Issued in MI

Legal business name

MICHIGAN ORTHOPAEDIC SPINE SURGEONS PC

Practice address

1555 South Blvd E
Suite 310
Rochester Hills, MI 48307-5605

Phone

(248) 215-8080

Fax

(248) 289-1086

NPI assigned

Jul 11, 2012

Last updated

May 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Richard W Easton, M.D,NPI 1083696355

Title

Medical Director

Phone

(248) 215-8095

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard W Easton, MD

  • Orthopaedic Surgery Physician
  • Rochester Hills, MI
  • NPI 1083696355
  Medicare reassignment Care Compare group NPD Authorized official
• Bradley D Ahlgren, MD

  • Orthopaedic Surgery Physician
  • Rochester Hills, MI
  • NPI 1790766871
  Medicare reassignment Care Compare group NPD
• Gratian Alexandru Moldovan

  • Nurse Practitioner
  • Troy, MI
  • NPI 1073327540
  Medicare reassignment Care Compare group NPD
• John Steven Papakonstantinou, MD

  • Orthopaedic Surgery Physician
  • Rochester Hills, MI
  • NPI 1679722888
  Medicare reassignment Care Compare group NPD
• Nicholas S. Papakonstantinou, M.D.

  • Orthopaedic Surgery Physician
  • Rochester Hills, MI
  • NPI 1407045602

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Nathan Rimmke

  • Orthopaedic Surgery Physician
  • Rochester Hills, MI
  • NPI 1780819490
  Medicare reassignment Care Compare group NPD
• Brady Thomas Vibert, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Rochester Hills, MI
  • NPI 1205870441
  Medicare reassignment Care Compare group NPD
• Scott Diamond, MD

  • Orthopaedic Surgery Physician
  • Pittsburgh, PA
  • NPI 1568992527

  MI

  Medicare reassignment Care Compare group NPD
• Michael Scott Broad, PA-C

  • Surgical Physician Assistant
  • Rochester Hills, MI
  • NPI 1356380935
  Medicare reassignment Care Compare group
• Matthew Cain, PA-C

  • Medical Physician Assistant
  • Auburn Hills, MI
  • NPI 1649420217
  Medicare reassignment Care Compare group
• Thomas James Klick Jr., PA-C

  • Surgical Physician Assistant
  • Troy, MI
  • NPI 1972884740
  Medicare reassignment Care Compare group
• Brent S. Lotterman, PA-C

  • Physician Assistant
  • Port Huron, MI
  • NPI 1881889053
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1972868321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SOUTH BLVD E",
            "address_2": "SUITE 310",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075605",
            "telephone_number": "248-215-8080",
            "fax_number": "248-289-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOUTH BLVD E",
            "address_2": "SUITE 310",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075605",
            "telephone_number": "248-215-8080",
            "fax_number": "248-289-1086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29624 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480730905",
            "country_code": "US",
            "telephone_number": "248-215-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4550 Investment Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480986334",
            "country_code": "US",
            "telephone_number": "248-215-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1375 N Main St",
            "address_purpose": "LOCATION",
            "city": "Lapeer",
            "state": "MI",
            "postal_code": "484461350",
            "country_code": "US",
            "telephone_number": "248-215-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1349 S Rochester Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483073186",
            "country_code": "US",
            "telephone_number": "248-215-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22401 Foster Winter Dr",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480753724",
            "country_code": "US",
            "telephone_number": "248-215-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIGAN ORTHOPAEDIC SPINE SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-05-06",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "EASTON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-215-8095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301051364",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301054228",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301075858",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MI",
            "license": "4301087222",
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.