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DR. MICHAEL THOMAS CONVERTINO MD
NPI 1811570534
Student in an Organized Health Care Education/Training Program in Southfield, MI

Active since April 30, 2021PECOS EnrolledAccepts Medicare Assignment
22250 PROVIDENCE DR STE 301, SOUTHFIELD, MI 48075(248) 849-3281(248) 849-5449 Get Directions Write a Review

NPPES record last updated: April 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael Thomas Convertino Md NPPES

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

DR. MICHAEL THOMAS CONVERTINO MD (NPI 1811570534) is an individual student in an organized health care education/training program in Southfield, Michigan and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1811570534
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. MICHAEL THOMAS CONVERTINOCredential: MD
Location Address22250 PROVIDENCE DR STE 301Southfield, MI 48075-6211
Mailing Address22250 Providence DrSouthfield, MI 48075-4825 · (248) 849-3281 · Fax (248) 849-5449
Phone(248) 849-3281
Fax(248) 849-5449
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 30, 2021
NPPES CertifiedApril 28, 2021
✔ NPI 1811570534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
22250 PROVIDENCE DR STE 301, Southfield, MI 48075
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Thomas Convertino Md 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 ID3577966761
PECOS Enrollment IDI20240329002157
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.

Hospital Affiliations CMS Care Compare

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

Other Providers at the Same Location NPPES 15

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

MR. AMMAR WADI ALKHAFAJI MD
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
SALAM BRIKHO M.D., M.S.
General Practice
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
ANDREW BACHA
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
DR. JOELLE FAKIH MD
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
JIRIES ISSA HADDAD DO
Student in an Organized Health Care Education/Training Program
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
JACOB ALEX
Student in an Organized Health Care Education/Training Program
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-4818
JEREMY REID HEFFERNAN M.D.
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
DR. ABHISHEK SUSHIL SHASTRY DO
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281

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 Convertino's NPI number?

The NPI number for Michael Convertino is 1811570534. It was assigned to this individual provider in the NPPES registry on April 30, 2021.

Where is Michael Convertino located?

Michael Convertino practices at 22250 Providence Dr Ste 301, Southfield, MI 48075. The listed phone number is (248) 849-3281.

What is Michael Convertino's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michael Convertino enrolled in Medicare?

Yes. Michael Convertino 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.

What insurance does Michael Convertino accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Michael Convertino 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 Convertino affiliated with any hospitals?

According to CMS data, Michael Convertino is affiliated with Ascension Providence Hospital, Southfield And Novi.

When was this NPI record last updated?

The NPPES record for Michael Convertino was last updated on April 30, 2021. 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.