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GREAT LAKES PHYSICIANS PC
NPI 1164591053
Internal Medicine in Livonia, MI

Active since November 07, 2006
36180 FIVE MILE ROAD, LIVONIA, MI 48154(734) 591-7666(734) 591-2426 Get Directions Write a Review

NPPES record last updated: September 28, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Great Lakes Physicians Pc NPPES

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

GREAT LAKES PHYSICIANS PC (NPI 1164591053) is a healthcare organization registered as an internal medicine in Livonia, Michigan and active in the NPI registry since November 2006. The organization lists Jayshree Desai, Owner, as its authorized official.

NPPES Registry Identity

NPI1164591053
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameGREAT LAKES PHYSICIANS PC
Location Address36180 FIVE MILE ROADLivonia, MI 48154
Mailing Address36180 Five Mile RoadLivonia, MI 48154 · (734) 591-7666 · Fax (734) 591-2426
Phone(734) 591-7666
Fax(734) 591-2426
Organization SubpartNo
Authorized OfficialJayshree DesaiOwner · (734) 591-7666
Enumeration DateNovember 7, 2006
Last NPPES UpdateSeptember 28, 2012
✔ NPI 1164591053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
36180 FIVE MILE ROAD, Livonia, MI 48154
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Other Identifiers 2

Medicaid3323140MI
Medicare ID-Type Unspecified0P38630MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Great Lakes Physicians Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Great Lakes Physicians PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jayshree Desai, MD
Internal Medicine
NPI 1396752283
36180 FIVE MILE ROAD
Livonia, MI 48154
(734) 591-7666
✔ PECOS✔ Accepts MedicareSame address
Surendra Kelwala, MD
Psychiatry
NPI 1558475517
36180 FIVE MILE RD
Livonia, MI 48154
(734) 591-7666
✔ PECOS✔ Accepts MedicareSame address

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 Great Lakes Physicians PC's NPI number?

The NPI number for Great Lakes Physicians PC is 1164591053. It was assigned to this organization in the NPPES registry on November 7, 2006.

Where is Great Lakes Physicians PC located?

Great Lakes Physicians PC is located at 36180 Five Mile Road, Livonia, MI 48154. The listed phone number is (734) 591-7666.

What is Great Lakes Physicians PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Great Lakes Physicians PC enrolled in Medicare?

Yes. Great Lakes Physicians PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great Lakes Physicians PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Great Lakes Physicians PC, in Internal Medicine and Psychiatry. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Great Lakes Physicians PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Great Lakes Physicians PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Great Lakes Physicians PC was last updated on September 28, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.