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MMG 1 PC
NPI 1023037025
Nurse Practitioner in Southfield, MI

Active since July 19, 2006
28625 NORTHWESTERN HWY, SUITE 213, SOUTHFIELD, MI 48034(248) 354-9666(248) 354-3653 Get Directions Write a Review

NPPES record last updated: May 24, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 24, 2021, Sep 20, 2018 (2 updates tracked since 2018).

About Mmg 1 Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MMG 1 PC (NPI 1023037025) is a healthcare organization registered as a nurse practitioner in Southfield, Michigan and active in the NPI registry since July 2006. The organization lists Geoffrey A Trivax, President, as its authorized official.

NPPES Registry Identity

NPI1023037025
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameMMG 1 PC
Location Address28625 NORTHWESTERN HWY, SUITE 213Southfield, MI 48034-1828
Mailing Address29992 Northwestern Hwy Ste CFarmington Hills, MI 48334-3292 · (248) 851-1430 · Fax (248) 851-5182
Phone(248) 354-9666
Fax(248) 354-3653
Organization SubpartNo
Authorized OfficialGeoffrey A TrivaxPresident · (313) 538-3099
Enumeration DateJuly 19, 2006
Last NPPES UpdateMay 24, 20212 updates tracked since enumeration
NPPES CertifiedMay 24, 2021
✔ NPI 1023037025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
28625 NORTHWESTERN HWY, Southfield, MI 48034
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Other Identifiers 1

Other500F318990MI · Blue Shield Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mmg 1 Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

29

Medicare enrollment records show 29 clinicians reassign Medicare billing to Mmg 1 PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 20 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Diagnostic Radiology13
Cardiovascular Disease (Cardiology)6
Interventional Cardiology3
Internal Medicine2
Interventional Radiology2
Physical Medicine and Rehabilitation2
Pulmonary Disease1

Nearest to this location (20)

See all 29
Herman Kado, M.D.
Cardiovascular Disease (Cardiology)
NPI 1033367362
28625 NORTHWESTERN HWY SUITE 150
Southfield, MI 48034
(248) 587-2300
✔ PECOS✔ Accepts MedicareSame address
Stephen Gunther, MD
Cardiovascular Disease (Cardiology)
NPI 1205942182
26400 W 12 MILE RD SUITE 120
Southfield, MI 48034
(248) 304-3200
✔ PECOS0.4 mi
Justin Trivax, M.D.
Interventional Cardiology
NPI 1174566095
31500 TELEGRAPH RD SUITE 115
Bingham Farms, MI 48025
(248) 594-4913
✔ PECOS✔ Accepts Medicare1.8 mi
Steven Korotkin, MD
Cardiovascular Disease (Cardiology)
NPI 1396736179
32270 TELEGRAPH RD STE 100
Bingham Farms, MI 48025
(248) 258-2888
✔ PECOS✔ Accepts Medicare2.1 mi
Dustin Feldman, D.O.
Interventional Cardiology
NPI 1689894867
32255 NORTHWESTERN HWY STE 50
Farmington Hills, MI 48334
(947) 227-8420
✔ PECOS✔ Accepts Medicare2.9 mi
Jonathan Olsen, M.D.
Diagnostic Radiology
NPI 1700198561
32255 NORTHWESTERN HWY STE 135
Farmington Hills, MI 48334
(947) 228-5500
✔ PECOS✔ Accepts Medicare2.9 mi
Stephen Vartanian, MD
Interventional Radiology
NPI 1790990919
32255 NORTHWESTERN HWY STE 135
Farmington Hills, MI 48334
(947) 228-5500
✔ PECOS✔ Accepts Medicare2.9 mi
Eric Greenberg, DO
Cardiovascular Disease (Cardiology)
NPI 1689812489
32255 NORTHWESTERN HWY STE 115
Farmington Hills, MI 48334
(248) 587-2300
✔ PECOS✔ Accepts Medicare2.9 mi
James Lyddon, DO
Diagnostic Radiology
NPI 1992770986
32255 NORTHWESTERN HWY STE 100
Farmington Hills, MI 48334
(248) 945-0000
✔ PECOS✔ Accepts Medicare2.9 mi
Daya Vora, M.D.
Diagnostic Radiology
NPI 1023218153
32255 NORTHWESTERN HWY STE 100
Farmington Hills, MI 48334
(248) 945-0000
✔ PECOS✔ Accepts Medicare2.9 mi
George Dirani, M.D
Interventional Cardiology
NPI 1619310885
32255 NORTHWESTERN HWY STE 115
Farmington Hills, MI 48334
(248) 587-2300
✔ PECOS✔ Accepts Medicare2.9 mi
Harvey Sabbota, D.O.
Internal Medicine
NPI 1306836390
32255 NORTHWESTERN HWY STE 130
Farmington Hills, MI 48334
(248) 723-5880
✔ PECOS2.9 mi
Eugene Tryciecky, DO
Diagnostic Radiology
NPI 1467522961
28050 GRAND RIVER AVE
Farmington Hills, MI 48336
(248) 471-8371
✔ PECOS✔ Accepts Medicare3.7 mi
Roshni Shah, D.O.
Cardiovascular Disease (Cardiology)
NPI 1962705004
22250 PROVIDENCE DR STE 705
Southfield, MI 48075
(248) 552-9858
✔ PECOS✔ Accepts Medicare5.7 mi
Syed Jafri, MD
Diagnostic Radiology
NPI 1467412221
3601 W 13 MILE RD
Royal Oak, MI 48073
(248) 551-6069
✔ PECOS✔ Accepts Medicare5.8 mi
Adam Tawney, MD
Cardiovascular Disease (Cardiology)
NPI 1962865147
3601 W 13 MILE RD
Royal Oak, MI 48073
(313) 473-1000
✔ PECOS✔ Accepts Medicare5.8 mi
Michael Savin, M.D.
Interventional Radiology
NPI 1821059049
3601 W 13 MILE RD
Royal Oak, MI 48073
(248) 898-6064
✔ PECOS✔ Accepts Medicare5.8 mi
Anindya Roy, MD
Diagnostic Radiology
NPI 1083674071
3601 W 13 MILE RD
Royal Oak, MI 48073
(248) 423-2481
✔ PECOS✔ Accepts Medicare5.9 mi
Garrett Walworth, M.D.
Diagnostic Radiology
NPI 1598794927
3601 W 13 MILE RD
Royal Oak, MI 48073
(248) 898-6064
✔ PECOS✔ Accepts Medicare5.9 mi
Michael Haenick, MD
Physical Medicine and Rehabilitation
NPI 1235127770
42350 GRAND RIVER AVE
Novi, MI 48375
(248) 697-2942
✔ PECOS✔ Accepts Medicare8.3 mi
See all 29 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mmg 1 PC's NPI number?

The NPI number for Mmg 1 PC is 1023037025. It was assigned to this organization in the NPPES registry on July 19, 2006.

Where is Mmg 1 PC located?

Mmg 1 PC is located at 28625 Northwestern Hwy Suite 213, Southfield, MI 48034. The listed phone number is (248) 354-9666.

What is Mmg 1 PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mmg 1 PC enrolled in Medicare?

Yes. Mmg 1 PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mmg 1 PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 29 clinicians in 7 Medicare specialties reassign their Medicare billing to Mmg 1 PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (13), Cardiovascular Disease (Cardiology) (6) and Interventional Cardiology (3). Of these, 1 practice at this address and 20 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mmg 1 PC was last updated on May 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.