Individual provider Active NPI

Monique R Ice, MD

  • Emergency Medicine Physician
  • Flint, MI
National Provider Identifier
1992721641
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301089423 Issued in MI
Practice address
1 Hurley PLZ # Ed
Flint, MI 48503-5902
Phone
(810) 262-9429
Fax
(810) 262-9104
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35-086356 OH
Emergency Medicine Physician 207P00000X 4301089423 MI Primary

Addresses

Primary practice location

1 Hurley PLZ # Ed
Flint, MI 48503-5902

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other practice location 1

1500 East Medical Center Dr
B1 floor University Hospital Recp Emergency
Ann Arbor, MI 48109-5301
Phone (734) 936-6666

Other identifiers 2

IdentifierTypeStateIssuer
2594241MedicaidOH
P00266147OtherOHRAILROAD MEDICARE

Other names 1

  • Monique R Averill Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mice7582@direct.hurleymc.com

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
I20070724000400 MI Practitioner - Emergency Medicine 6103841093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

1 Hurley Plasa
9W Hurley Maternal Fetal Medicine
Flint, MI 48503-5902
Phone (810) 262-4787

1 Hurley PLZ
Flint, MI 48503-5902

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.4 of 100Reported as group
Quality
66.97
Promoting interoperability
100
Improvement activities
40
Cost
75.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-086356OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center Emergency Medicine CurrentSince Aug 1, 2007 Accepting new patients
Pathology Associates Inc PC Current Accepting new patients
Hurley Medical Center CurrentSince Aug 1, 2007 Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

Interoperability endpoints

  • Direct secure messaging: mice7582@direct.hurleymc.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1992721641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ # ED",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9429",
            "fax_number": "810-262-9104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Dr",
            "address_2": "B1 floor University Hospital Recp Emergency",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095301",
            "country_code": "US",
            "telephone_number": "734-936-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICE",
        "first_name": "MONIQUE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35-086356",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301089423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2594241",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00266147",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mice7582@direct.hurleymc.com",
            "affiliation": "N",
            "address_1": "1 Hurley Plz # Ed",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485035902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MONIQUE",
            "last_name": "AVERILL",
            "middle_name": "R",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.