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MY KIDS DOC-SOUTHFIELD
NPI 1730187840
Pediatrics - Adolescent Medicine in Southfield, MI

Active since July 12, 2005CLIA 23D1010247 · Microscopy
29255 NORTHWESTERN HWY, SUITE 100, SOUTHFIELD, MI 48034(248) 358-2410(248) 358-2470 Get Directions Write a Review

NPPES record last updated: April 29, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About My Kids Doc-southfield NPPES

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

MY KIDS DOC-SOUTHFIELD (NPI 1730187840) is a healthcare organization registered as an adolescent medicine in Southfield, Michigan and active in the NPI registry since July 2005. The organization holds a CLIA Microscopy certificate valid through March 9, 2027 and lists Pamela Berry, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1730187840
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameMY KIDS DOC-SOUTHFIELD
Location Address29255 NORTHWESTERN HWY, SUITE 100Southfield, MI 48034-1018
Mailing AddressPo Box 33321, Drawer 117Detroit, MI 48232-5321 · (248) 358-2410 · Fax (248) 358-2470
Phone(248) 358-2410
Fax(248) 358-2470
Organization SubpartNo
Authorized OfficialPamela BerryOwner/physician · (248) 358-2410
Enumeration DateJuly 12, 2005
Last NPPES UpdateApril 29, 2009
✔ NPI 1730187840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in MI · PB047877
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
29255 NORTHWESTERN HWY, Southfield, MI 48034
Open in Google Maps ↗

Other Identifiers 3

Other350F300680MI · Bcn Group
Other350F300680MI · Bcbs Group
Medicaid1730187840MI

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 for Provider-Performed Microscopy Procedures (PPMP) 23D1010247

My Kids Doc Southfield, PLLC · Southfield, MI
Active · expires Mar 9, 2027
CLIA Number23D1010247
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2025
Certificate Expiration DateMarch 9, 2027
Laboratory DirectorMarie Jeanne D. Monde Matthews
Laboratory Phone(248) 358-2410
Laboratory LocationMy Kids Doc Southfield, PLLC29255 Northwestern Suite 115, Southfield, MI 48034
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

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

DR. MAYNARD BUSZEK M.D.
Physical Medicine & Rehabilitation (Pain Medicine)
29255 NORTHWESTERN HWY, SUITE 201
SOUTHFIELD, MI 48034
Oakland County (248) 368-0100
ASHLEY ANN ZAYAT CPNP-PC
Nurse Practitioner (Pediatrics)
29255 NORTHWESTERN HWY
SOUTHFIELD, MI 48034
Oakland County (248) 358-2410
ACE PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
29255 NORTHWESTERN HWY, SUITE 101
SOUTHFIELD, MI 48034
Oakland County (248) 469-4469
PHYSICAL MEDICINE CONSULTANTS PC
Physical Medicine & Rehabilitation (Pain Medicine)
29255 NORTHWESTERN HWY
SOUTHFIELD, MI 48034
Oakland County (248) 368-0100
HOME REHAB SPECIALISTS, LLC
Home Health
29255 NORTHWESTERN HWY, SUITE 302
SOUTHFIELD, MI 48034
Oakland County (248) 352-7301
DR. RODRIGO TOBAR JR. DO
Family Medicine
29255 NORTHWESTERN HWY, SUITE 203
SOUTHFIELD, MI 48034
Oakland County (248) 557-0535
MR. JOHN KRAUSS P.T.
Physical Therapist
29255 NORTHWESTERN HWY, SUITE 300
SOUTHFIELD, MI 48034
Oakland County (248) 353-1234
FAMILY MEDICINE PC
Family Medicine
29255 NORTHWESTERN HWY, SUITE 203
SOUTHFIELD, MI 48034
Oakland County (248) 557-0535

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 My Kids Doc-Southfield's NPI number?

The NPI number for My Kids Doc-Southfield is 1730187840. It was assigned to this organization in the NPPES registry on July 12, 2005.

Where is My Kids Doc-Southfield located?

My Kids Doc-Southfield is located at 29255 Northwestern Hwy Suite 100, Southfield, MI 48034. The listed phone number is (248) 358-2410.

What is My Kids Doc-Southfield's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does My Kids Doc-Southfield hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D1010247) is associated with this NPI, valid through March 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does My Kids Doc-Southfield 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 My Kids Doc-Southfield 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 My Kids Doc-Southfield was last updated on April 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.