PEDIATRIC SPECIALTY GROUP – NPI #1821049990
Pediatrics

A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.

Health Care Provider Taxonomy Code for Pediatrics

PEDIATRIC SPECIALTY GROUP is a provider located in CILNTON TOWNSHIP, MI. NPPES has assigned the NPI number 1821049990 to PEDIATRIC SPECIALTY GROUP on May 13, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PEDIATRIC SPECIALTY GROUP” is a dba name, the actual legal business name for this organization is MCLAREN MACOMB. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2080P0008X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Neurodevelopmental Disabilities

The NPI profile was previously updated about 8 years ago on May 23, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PEDIATRIC SPECIALTY GROUP below.

NPI Profile for
MCLAREN MACOMB

NPI Number
1821049990
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MCLAREN MACOMB
Doing Business As (dba): PEDIATRIC SPECIALTY GROUP
Primary location
43900 GARFIELD RD
STE. 201
CILNTON TOWNSHIP, MI 48038
Phone: (586) 412-5110 Fax: (586) 412-5116
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
THOMAS BRISSE
CEO
Phone: (586) 493-8083
Updated
Identifiers

Identifiers for PEDIATRIC SPECIALTY GROUP

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMI3518937
MEDICAIDMI3298762
MEDICAIDMI3298780
MEDICAIDMI4168314
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080P0008X
- Pediatrics / Neurodevelopmental Disabilities (Primary)
2080P0202X
- Pediatrics / Pediatric Cardiology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.