HENRY FORD SEMI MEDICAL GROUP – Endocrinology, Diabetes & Metabolism Physician, NPI 1114133485
Endocrinology, Diabetes & Metabolism Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for HENRY FORD SEMI MEDICAL GROUP
PO BOX 670884
DETROIT, MI 482670884
Phone:
Type: Mailing
26850 PROVIDENCE PKWY
NOVI, MI 483741213
Phone: (248) 680-8000
Fax: (248) 292-3852
Type: Location
2800, Livernois Road, Troy, Oakland County, Michigan, 48083, United States
SUITE 500
TROY, MI 480831215
Phone: (248) 680-8000
Fax: (248) 680-8031
Type: Mailing
PO BOX 14129
BELFAST, ME 049154032
Phone: (248) 680-8000
Fax: (248) 292-3852
Type: Mailing
28000 DEQUINDRE ROAD
REVENUE CYCLE DEPARTMENT
WARREN, MI 480921215
Phone: (248) 680-8000
Fax: (248) 292-3852
Type: Mailing
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-10-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-10-31 (226 days ago).
Enrollment records
2
Earliest due date
2025-10-31
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 |
|---|---|---|---|---|
| O20031219000422 | O | Clinic/Group Practice | MI | TBD |
| O20081015000289 | O | Clinic/Group Practice | MI | 2025-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48267)
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