CMS-1500 Box 24J / 33a • NPI
1528851607
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207R00000X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
41800 W 11 MILE RD STE 109, NOVI, MI, 48375-1818
✓ 9-Digit EDI 837 ZIP+4 (48375-1818)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1528851607 (COMPLEXCARE MEDICAL GROUP MIDWEST M PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1528851607 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | COMPLEXCARE MEDICAL GROUP MIDWEST M PLLC |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207R00000X (Internal Medicine) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 41800 W 11 MILE RD STE 109, NOVI, MI, 48375-1818 |
| Practice Telephone / Fax | Tel: (248) 660-1220 | Fax: (248) 218-9996 |
| Administrative Mailing Address | 41800 W 11 MILE RD STE 109, NOVI, MI, 48375-1818 |
| Enumeration & Last Sync | Enumerated: 2025-05-22 | CMS Record Updated: 2026-06-26 |
| Authorized Official | SVETLANA VINOKUR (CFO) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207R00000X)
What Does Taxonomy Code 207R00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207R00000X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (COMPLEXCARE MEDICAL GROUP MIDWEST M PLLC)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363L00000X — Nurse PractitionerPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner | State: N/A | License: Verified | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: N/A | License: Verified | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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