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ADAM ROURKE DO
NPI 1225284763
Otolaryngology - Facial Plastic Surgery in Sterling Heights, MI

Active since August 15, 2008PECOS EnrolledAccepts Medicare Assignment
81.91/100
CMS Quality Rating
11080 HALL RD, SUITE A, STERLING HEIGHTS, MI 48314(586) 254-7200(586) 254-7201 Get Directions Write a Review

NPPES record last updated: September 11, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Adam Rourke Do NPPES

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

ADAM ROURKE DO (NPI 1225284763) is an individual facial plastic surgery provider in Sterling Heights, Michigan, licensed in Michigan (5101017814) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Michigan State University College Of Osteopathic Medicine (2008).

NPPES Registry Identity

NPI1225284763
Entity TypeIndividualMale
Primary Taxonomy207YS0123X
Provider Legal NameADAM ROURKECredential: DO
Location Address11080 HALL RD, SUITE ASterling Heights, MI 48314-1511
Mailing Address11080 Hall Rd, Suite ASterling Heights, MI 48314-1511 · (586) 254-7200 · Fax (586) 254-7201
Phone(586) 254-7200
Fax(586) 254-7201
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2008
Enumeration DateAugust 15, 2008
Last NPPES UpdateSeptember 11, 2014
✔ NPI 1225284763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YS0123X
License✔ Licensed in MI · 5101017814
Definition
An otolaryngologist who specializes in facial plastic surgery.
11080 HALL RD, Sterling Heights, MI 48314
Open in Google Maps ↗

Other Identifiers 2

Other700F399670MI · Bcbsm Group Pin
Medicare PINMI5551MI

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, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Adam Rourke Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951540004
PECOS Enrollment IDI20140930002970
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Adam Rourke reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lakeshore Ear Nose And Throat Center PC
Same address
Otolaryngology
11080 HALL RD, A
Sterling Heights, MI 48314
  • Reassigned Medicare billing, Michigan enrollment
  • 19 clinicians in this Medicare group
NPI 1285803346 (586) 254-7200
Henry Ford Health St. John Hospital
9.7 mi
Podiatrist
26755 BALLARD ST
Harrison Township, MI 48045
  • Reassigned Medicare billing, Michigan enrollment
  • 520 clinicians in this Medicare group
NPI 1043478910 (584) 655-5501

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

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
335 services246 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
222 services192 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
198 services137 patients
Comprehensive hearing and speech recognition test 92557
A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.
192 services178 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
146 services146 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
135 services135 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230047
Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County
Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230089
Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

Ascension Providence Rochester Hospital

Acute Care Hospitals · Rochester, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230254
Location1101 W University DriveRochester, MI 48307 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230269
Location44201 Dequindre RoadTroy, MI 48085 · Oakland County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.91/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality76.38
Promoting Interoperability83
Improvement Activities40

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use
98%130 patients
Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
8%131 patients4/55-star benchmark: 100%
Breast Cancer Screening
1%754 patients1/55-star benchmark: 93%
Cervical Cancer Screening
1%947 patients1/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
10%52 patients1/55-star benchmark: 87%
Controlling High Blood Pressure
5%136 patients1/55-star benchmark: 91%
Diabetes: Eye Exam
0%58 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%58 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
98%4,076 patients4/55-star benchmark: 100%
e-Prescribing
94%646 patients2/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%1,184 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
20%3,098 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
0%3,085 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
0%3,431 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 0% · 1,715 patients
0%1,715 patients
Provide Patients Electronic Access to Their Health Information
58%979 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
81%298 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 1,244 patients
Patients totalRate: 0% · 1,244 patients
0%1,244 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN W BECKER MD
Otolaryngology
11080 HALL RD, STE A
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-7200
DR. DAVID A SCAPINI MD
Otolaryngology
11080 HALL RD, STE A
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-7200
LAKESHORE EAR NOSE AND THROAT CENTER PC
Otolaryngology
11080 HALL RD, A
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-7200
EMILY JOHNSON AU.D
Audiologist
11080 HALL RD
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-0033
ROOPAL A CHITNIS
Audiologist-Hearing Aid Fitter
11080 HALL RD
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-7200
DR. KATHERINE MARIE GREENING AU.D.
Audiologist
11080 HALL RD
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-0033
SUSAN WHITEHEAD POTTER
Audiologist-Hearing Aid Fitter
11080 HALL RD
STERLING HEIGHTS, MI 48314
Macomb County (586) 254-7200
ENT PHYSICIANS,P.C
Otolaryngology
11080 HALL RD
STERLING HTS, MI 48314
Macomb County (586) 254-7200

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 Adam Rourke's NPI number?

The NPI number for Adam Rourke is 1225284763. It was assigned to this individual provider in the NPPES registry on August 15, 2008.

Where is Adam Rourke located?

Adam Rourke practices at 11080 Hall Rd Suite A, Sterling Heights, MI 48314. The listed phone number is (586) 254-7200.

What is Adam Rourke's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

Is Adam Rourke enrolled in Medicare?

Yes. Adam Rourke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Adam Rourke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adam Rourke reassigns Medicare benefits to 2 organizations: Lakeshore Ear Nose And Throat Center PC (Sterling Heights, MI) and Henry Ford Health St. John Hospital (Harrison Township, MI). Each 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 Adam Rourke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Adam Rourke accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Adam Rourke 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.

Is Adam Rourke affiliated with any hospitals?

According to CMS data, Adam Rourke is affiliated with Henry Ford Macomb Hospital, Beaumont Hospital - Grosse Pointe, Beaumont Hospital Royal Oak, Ascension Providence Rochester Hospital and Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Adam Rourke was last updated on September 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.