PROMED PRIMARY CARE PLLC
NPI 1336808864
Family Medicine in Roseville, MI

Q: What is Promed Primary Care PLLC's NPI number?

The NPI number for Promed Primary Care PLLC is 1336808864. It was assigned to this organization in the NPPES registry on December 13, 2021.

Q: What is Promed Primary Care PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since December 13, 2021CLIA 23D2245670 · Waiver

19041 E 12 MILE RD STE 103, ROSEVILLE, MI 48066(586) 252-9737(586) 252-2909 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 19, 2025, Dec 13, 2021 (2 updates tracked since 2021).

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About Promed Primary Care Pllc NPPES

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

PROMED PRIMARY CARE PLLC (NPI 1336808864) is a healthcare organization registered as a family medicine in Roseville, Michigan and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through December 14, 2027 and lists Manolis Kyriacou, Owner, as its authorized official.

NPPES Registry Identity

NPI1336808864

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePROMED PRIMARY CARE PLLC

Location Address19041 E 12 MILE RD STE 103Roseville, MI 48066-2609

Mailing Address19041 E 12 Mile Rd Ste 103Roseville, MI 48066-2609 · (586) 252-9737 · Fax (586) 252-2909

Phone(586) 252-9737

Fax(586) 252-2909

Organization SubpartNo

Authorized OfficialManolis KyriacouOwner · (586) 252-9737

Enumeration DateDecember 13, 2021

Last NPPES UpdateMarch 19, 20252 updates tracked since enumeration

NPPES CertifiedMarch 19, 2025

✔ NPI 1336808864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

19041 E 12 MILE RD STE 103, Roseville, MI 48066

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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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2245670

Promed Primary Care PLLC · Roseville, MI

Active · expires Dec 14, 2027

CLIA Number23D2245670

Laboratory TypePhysician Office

Certificate Effective DateDecember 15, 2025

Certificate Expiration DateDecember 14, 2027

Laboratory DirectorKyriacou Manolis

Laboratory Phone(586) 252-2937

Laboratory LocationPromed Primary Care PLLC19041 E 12 Mile Road Suite 103, Roseville, MI 48066

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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 Promed Primary Care PLLC's NPI number?

The NPI number for Promed Primary Care PLLC is 1336808864. It was assigned to this organization in the NPPES registry on December 13, 2021.

Where is Promed Primary Care PLLC located?

Promed Primary Care PLLC is located at 19041 E 12 Mile Rd Ste 103, Roseville, MI 48066. The listed phone number is (586) 252-9737.

What is Promed Primary Care PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Promed Primary Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2245670) is associated with this NPI, valid through December 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Promed Primary Care PLLC 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 list Promed Primary Care PLLC 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 Promed Primary Care PLLC was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.