WESTERN WAYNE PHYSICIANS, PLC
NPI 1629263520
Family Medicine in Allen Park, MI
About Western Wayne Physicians, Plc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WESTERN WAYNE PHYSICIANS, PLC (NPI 1629263520) is a healthcare organization registered as a family medicine in Allen Park, Michigan and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through January 5, 2027 and lists Robert J Jackson, Owner / Secretary, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 12
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Western Wayne Physicians, Plc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Western Wayne Physicians, Plc, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 11 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (16)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 23D0712306
Western Wayne Physicians Plc · Allen Park, MIFrequently 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 Western Wayne Family Physicians, Plc's NPI number?
The NPI number for Western Wayne Family Physicians, Plc is 1629263520. It was assigned to this organization in the NPPES registry on September 13, 2007. The provider is doing business as Western Wayne Physicians, Plc.
Where is Western Wayne Family Physicians, Plc located?
Western Wayne Family Physicians, Plc is located at 7445 Allen Rd Suite 250, Allen Park, MI 48101. The listed phone number is (313) 386-5500.
What is Western Wayne Family Physicians, Plc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Western Wayne Family Physicians, Plc enrolled in Medicare?
Yes. Western Wayne Family Physicians, Plc is registered in the Medicare PECOS enrollment system.
When is Western Wayne Family Physicians, Plc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Western Wayne Family Physicians, Plc?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 2 Medicare specialties reassign their Medicare billing to Western Wayne Family Physicians, Plc. 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 Family Practice (14) and Nurse Practitioner (2). Of these, 4 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Western Wayne Family Physicians, Plc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D0712306) is associated with this NPI, valid through January 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Western Wayne Family Physicians, Plc accept?
Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Western Wayne Family Physicians, Plc 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 Western Wayne Family Physicians, Plc was last updated on March 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Western Wayne Physicians, Plc · NPI 1629263520
Family Medicine organization in Allen Park, Michigan. Organization record, active in the CMS NPPES registry since September 13, 2007.
## Identity
- **NPI:** 1629263520 (Entity type: Organization)
- **Enumerated:** September 13, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Western Wayne Family Physicians, Plc
- **Organization subpart:** No
- **Authorized official:** Robert Jackson, OWNER / SECRETARY
## Practice location
- **Address:** 7445 ALLEN RD, SUITE 250, Allen Park, MI 48101-1963
- **Phone:** (313) 386-5500 · **Fax:** (313) 386-3444
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 16 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (14), Nurse Practitioner (2); 4 practice at this address and 11 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 18, 2008
- **Other identifiers:** Medicare PIN 0P30370 (MI); Medicaid 4172611 (MI); Medicaid 4545053 (MI); and 9 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1629263520) · Data from the CMS NPPES public registry.