ST. CLAIR NEPHROLOGY, IDAHO NEPHROLOGY ASSOCIATES
NPI 1154361616
Internal Medicine - Nephrology in Roseville, MI
NPI Status: Active since June 06, 2006
Contact Information
18001 E 10 MILE RD
SUITE 1
ROSEVILLE, MI
ZIP 48066
Phone: (586) 218-5800
Fax: (586) 532-6496
- Organization
- Internal Medicine
- Nephrology
- Accepts Insurance
- CLIA Number: 23D2100285
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-11-2027
About ST. CLAIR NEPHROLOGY, IDAHO NEPHROLOGY ASSOCIATES
This page provides the complete NPI Profile along with additional information for St. Clair Nephrology, Idaho Nephrology Associates, an internist established in Roseville, Michigan operating as a Internal Medicine, focusing in nephrology . The healthcare provider is registered in the NPI registry with number 1154361616 assigned on June 2006. The practitioner's primary taxonomy code is 207RN0300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. St. Clair Nephrology, Idaho Nephrology Associates operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as St. Clair Nephrology, Idaho Nephrology Associates. The authorized official of this NPI record is Dr. Christopher Robert Provenzano Md (Ceo/managing Employee (w2))
- NPI
- 1154361616
- Provider Legal Name
- ST CLAIR SPECIALTY PHYSICIANS PC
- Other Organization Name
- ST. CLAIR NEPHROLOGY, IDAHO NEPHROLOGY ASSOCIATES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 18001 E 10 MILE RD SUITE 1 ROSEVILLE, MI 48066
- Location Phone
- (586) 218-5800
- Location Fax
- (586) 532-6496
- Mailing Address
- 45640 SCHOENHERR RD SHELBY TOWNSHIP, MI 48315
- Mailing Phone
- (586) 247-4300
- Mailing Fax
- (586) 532-6496
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-06-2006
- Last Update Date
- 10-17-2022
- Code Navigator
An internist like St. Clair Nephrology, Idaho Nephrology Associates is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Blue Cross� Local HMO Bronze Extra - HMO
- Blue Cross� Local HMO Bronze Secure - HMO
- Blue Cross� Local HMO Silver Extra - HMO
- Blue Cross� Local HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D2100285
- Facility Type
- Physician Office
- Certificate Effective Date
- August 12, 2025
- Certificate Expiration Date
- August 11, 2027
- Laboratory Director
- KEITH BELLOVICH
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to St. Clair Nephrology, Idaho Nephrology Associates in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1154361616, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
ROSEVILLE, MI 48066
ROSEVILLE, MI 48066
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154361616, enumerated as an "organization" on June 06, 2006.
The provider is located at 18001 E 10 MILE RD SUITE 1 ROSEVILLE, MI 48066 and the phone number is (586) 218-5800.
Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
