MICHIGAN DIAGNOSTIC PATHOLOGISTS, PLLC – Anatomic Pathology & Clinical Pathology Physician, NPI 1578734281
Anatomic Pathology & Clinical Pathology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MICHIGAN DIAGNOSTIC PATHOLOGISTS, PLLC
1468, Chemin Baisley, Madawaska County, New Brunswick, G5T 1P8, Canada
NOVI, MI 480991468
Phone:
Type: Mailing
5700 SOUTHWYCK BLVD
TOLEDO, OH 436141509
Phone:
Type: Mailing
Ascension Providence Hospital, Southfield Campus, 16001, West 9 Mile Road, Southfield, Oakland County, Michigan, 48075, United States
PROVIDENCE HOSPITAL, DEPARTMENT OF PATHOLOGY
SOUTHFIELD, MI 480754818
Phone: (248) 849-5401
Type: Location
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: 2008-08-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-04-30 (42 days ago).
Enrollment records
1
Earliest due date
2026-04-30
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 |
|---|---|---|---|---|
| O20080801000275 | O | Clinic/Group Practice | MI | 2026-04-30 |
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 48099)
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