Unknown Individual – Family Medicine Physician, NPI 1093734980
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
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Provider Addresses for Unknown Individual
Henry Ford Macomb Health Center - Fraser, 15717, 15 Mile Road, Cady, Clinton Township, Macomb County, Michigan, 48035, United States
CLINTON TWP, MI 48035
Phone: (586) 285-3800
Fax: (586) 285-3818
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100917000414 | I | Family Practice | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 173 | 142 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 111 | 109 | $0 |
| 81003 | Automated urinalysis test | 62 | 52 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 46 | 45 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 29 | 29 | $0 |
Insurance plans in this area (ZIP 48035)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Pediatric Medicine, Allergy/Immunology | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI |
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