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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: July 19, 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. MARIE-JEANNE D MONDE-MATTHEWS MD
Pediatrics
29255 NORTHWESTERN HWY, SUITE 100
SOUTHFIELD, MI 48034
Oakland County (248) 358-2410
DR. PAMELA BERRY MD
Pediatrics
29255 NORTHWESTERN HWY, SUITE 100
SOUTHFIELD, MI 48034
Oakland County (248) 358-2410
DR. SHARON LEE TICE MD
Pediatrics
29255 NORTHWESTERN HWY, SUITE 100
SOUTHFIELD, MI 48034
Oakland County (248) 358-2410
FAMILY MEDICINE PC
Family Medicine
29255 NORTHWESTERN HWY, SUITE 203
SOUTHFIELD, MI 48034
Oakland County (248) 557-0535
MR. MICHAEL N FAHMY PT
Physical Therapist
29255 NORTHWESTERN HWY, SUITE 300
SOUTHFIELD, MI 48034
Oakland County (248) 353-1234
NICOLE PATRICE METCALFE M.D.
Obstetrics & Gynecology
29255 NORTHWESTERN HWY, SUITE 301
SOUTHFIELD, MI 48034
Oakland County (248) 355-2852
GWENDOLYN WASHINGTON MD
Family Medicine
29255 NORTHWESTERN HWY, STE 105
SOUTHFIELD, MI 48034
Oakland County (248) 350-8890
DR. MAYNARD BUSZEK M.D.
Physical Medicine & Rehabilitation (Pain Medicine)
29255 NORTHWESTERN HWY, SUITE 201
SOUTHFIELD, MI 48034
Oakland County (248) 368-0100

Frequently Asked Questions

What is MY KIDS DOC-SOUTHFIELD's NPI number?

The NPI number assigned to this healthcare provider is 1730187840, enumerated as an "organization" on July 12, 2005.

Where is the provider located?

The provider is located at 29255 NORTHWESTERN HWY SUITE 100 SOUTHFIELD, MI 48034 and the phone number is (248) 358-2410.

What is the provider's specialty?

Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.

What insurance does MY KIDS DOC-SOUTHFIELD accept?

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.