HENRY FORD SEMI MEDICAL GROUP – Family Medicine Physician, NPI 1174537500
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for HENRY FORD SEMI MEDICAL GROUP
2800, Livernois Road, Troy, Oakland County, Michigan, 48083, United States
SUITE 500
TROY, MI 480831215
Phone: (248) 680-8000
Fax: (248) 680-8208
Type: Mailing
11900 E 12 Mile Rd Ste 301
Warren, MI 480933400
Phone: (586) 573-5600
Type: Location
PO BOX 14129
BELFAST, ME 049154032
Phone: (248) 680-8000
Fax: (248) 292-3852
Type: Mailing
PO BOX 670884
DETROIT, MI 482670884
Phone: (800) 999-5829
Type: Mailing
11900 E 12 MILE RD STE 210
WARREN, MI 480933490
Phone: (586) 582-7100
Fax: (586) 582-7101
Type: Location
28000 DEQUINDRE RD
WARREN, MI 480922468
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.
Medicare revalidation (CMS due date list)
Revalidation scheduled
Earliest CMS due date is 2026-10-31 (143 days away).
Enrollment records
1
Earliest due date
2026-10-31
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 |
|---|---|---|---|---|
| O20031113000362 | O | Clinic/Group Practice | MI | 2026-10-31 |
What to do next
- Monitor the published due date as it approaches.
- Plan to revalidate in PECOS within the window CMS allows before the due date.
- Verify the date on the CMS Revalidation Lookup Tool before submitting.
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 48083)
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