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MICHAEL BOUSAMRA II M.D.
NPI 1669411781
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Grosse Pointe Woods, MI

Active since June 05, 2006PECOS EnrolledAccepts Medicare Assignment
90.09/100
CMS Quality Rating
19229 MACK AVE STE 23, GROSSE POINTE WOODS, MI 48236(248) 849-2600(248) 849-2610 Get Directions Write a Review

NPPES record last updated: December 11, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 11, 2020, Aug 26, 2016 (2 updates tracked since 2016).

About Michael Bousamra Ii M.d. NPPES

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

MICHAEL BOUSAMRA II M.D. (NPI 1669411781) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Grosse Pointe Woods, Michigan, licensed in Michigan (4301503387) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and maintains a secondary practice location in New Albany.

NPPES Registry Identity

NPI1669411781
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameMICHAEL BOUSAMRA IICredential: M.D.
Location Address19229 MACK AVE STE 23Grosse Pointe Woods, MI 48236-2857
Mailing Address16001 W 9 Mile Rd Fl 3Southfield, MI 48075-4818 · (248) 849-2600 · Fax (248) 849-2610
Phone(248) 849-2600
Fax(248) 849-2610
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1985
Enumeration DateJune 5, 2006
Last NPPES UpdateDecember 11, 20202 updates tracked since enumeration
NPPES CertifiedDecember 11, 2020
✔ NPI 1669411781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Licenses✔ Licensed in MI · 4301503387✔ Licensed in IN · 01066681A✔ Licensed in KY · 35096
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
19229 MACK AVE STE 23, Grosse Pointe Woods, MI 48236
Open in Google Maps ↗

Secondary Practice Location 1

Location 12125 State St, Suite 3New Albany, IN 47150-4988 · Phone (812) 949-5575 · Fax (812) 949-5595

Other Identifiers 2

Medicaid64010325KY
Medicaid200204120IN

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

Michael Bousamra Ii M.d. 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 ID8628975885
PECOS Enrollment IDI20201217000213
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

4

Medicare enrollment records show Michael Bousamra reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Henry Ford Health Macomb-Oakland Hospital
7.6 mi
Family Medicine
11800 E 12 MILE RD
Warren, MI 48093
  • Reassigned Medicare billing, Michigan enrollment
  • 161 clinicians in this Medicare group
NPI 1134176472 (586) 573-5000
Henry Ford Health System
9.6 mi
Plastic Surgery
2799 W GRAND BLVD
Detroit, MI 48202
  • Reassigned Medicare billing, Michigan enrollment
  • 1,886 clinicians in this Medicare group
NPI 1528142858 (313) 916-2600
Seton Health Corporation Of Southeastern Michigan
14 mi
Family Medicine
15855 19 MILE RD
Clinton Township, MI 48038
  • Reassigned Medicare billing, Michigan enrollment
  • 111 clinicians in this Medicare group
NPI 1598177065 (248) 680-8000
Ascension Providence Hospital
17 mi
Psychiatry
16001 W 9 MILE RD, PHYSICIAN BILLING SERVICES
Southfield, MI 48075
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Henry Ford Health Providence Hospital
  • 393 clinicians in this Medicare group
NPI 1619932670 (248) 849-3000

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 9

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
88 services24 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
66 services46 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.
35 services35 patients
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.
32 services26 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
31 services25 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
29 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230019
Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County
Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Ascension Macomb Oakland Hosp-Warren Campus

Acute Care Hospitals · Warren, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230195
Location11800 East Twelve Mile RoadWarren, MI 48093 · Macomb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48236 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$177.36 typical visit price
range $58.04 – $177.36
Typical copayment $44.34 (range $14.51 – $44.34)
Most-billed visit code 99205
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

90.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.56
Promoting Interoperability100
Improvement Activities40
Cost54.6

Other Providers at the Same Location NPPES 2

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

DR. ANNA F BOSTON DNP-ANP-BC
Nurse Practitioner
19229 MACK AVE STE 23
GROSSE POINTE WOODS, MI 48236
Wayne County (313) 647-3252
DR. RICHARD NAZIH BERRI M.D.
Surgery
19229 MACK AVE STE 23
GROSSE POINTE WOODS, MI 48236
Wayne County (313) 647-3252

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 Michael Bousamra's NPI number?

The NPI number for Michael Bousamra is 1669411781. It was assigned to this individual provider in the NPPES registry on June 5, 2006.

Where is Michael Bousamra located?

Michael Bousamra practices at 19229 Mack Ave Ste 23, Grosse Pointe Woods, MI 48236. The listed phone number is (248) 849-2600.

What is Michael Bousamra's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Michael Bousamra enrolled in Medicare?

Yes. Michael Bousamra 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 Michael Bousamra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Bousamra reassigns Medicare benefits to 4 organizations: Henry Ford Health Macomb-Oakland Hospital (Warren, MI), Henry Ford Health System (Detroit, MI), Seton Health Corporation Of Southeastern Michigan (Clinton Township, MI) and Ascension Providence Hospital (Southfield, 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 Michael Bousamra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Bousamra 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 Michael Bousamra 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 Michael Bousamra affiliated with any hospitals?

According to CMS data, Michael Bousamra is affiliated with Ascension Providence Hospital, Southfield And Novi, Ascension St John Hospital and Ascension Macomb Oakland Hosp-Warren Campus.

When was this NPI record last updated?

The NPPES record for Michael Bousamra was last updated on December 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.