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DOROTHEA EDMUNDS DO
NPI 1982979449
Family Medicine in Brighton, MI

Active since March 16, 2012PECOS EnrolledAccepts Medicare Assignment
IHA PRIMARY CARE EAST BRIGHTON, 5505 S. OLD US 23 STE 100, BRIGHTON, MI 48116(810) 494-6885(517) 655-5976 Get Directions Write a Review

NPPES record last updated: June 8, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 8, 2023, Sep 15, 2016 (2 updates tracked since 2016).

About Dorothea Edmunds Do NPPES

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

DOROTHEA EDMUNDS DO (NPI 1982979449) is an individual family medicine provider in Brighton, Michigan, licensed in Michigan (5101019851) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS, is affiliated with St Joe Mercy Hospital System Livonia, and is a graduate of Michigan State University College Of Human Medicine (2012).

NPPES Registry Identity

NPI1982979449
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDOROTHEA EDMUNDSCredential: DO
Location AddressIHA PRIMARY CARE EAST BRIGHTON, 5505 S. OLD US 23 STE 100Brighton, MI 48116
Mailing Address24 Frank Lloyd Wright Drive, Suite J2000Ann Arbor, MI 48105 · (734) 747-6766 · Fax (517) 655-5976
Phone(810) 494-6885
Fax(517) 655-5976
Sole ProprietorNo
Medical School CMSMichigan State University College Of Human MedicineGraduated 2012
Enumeration DateMarch 16, 2012
Last NPPES UpdateJune 8, 20232 updates tracked since enumeration
NPPES CertifiedJune 8, 2023
✔ NPI 1982979449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 5101019851
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
IHA PRIMARY CARE EAST BRIGHTON, Brighton, MI 48116
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Other Names 1

Former Name (1)Dorothea Guilfoyle D.o.

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

Dorothea Edmunds Do 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 ID9931332558
PECOS Enrollment IDI20150604002406
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

2

Medicare enrollment records show Dorothea Edmunds reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Iha Health Services Corporation
1.0 mi
Family Medicine
5505 S OLD US 23 STE 100
Brighton, MI 48116
  • Reassigned Medicare billing, Michigan enrollment
  • 1,480 clinicians in this Medicare group
NPI 1760033245 (810) 494-6840
Edward W. Sparrow Hospital Association
28 mi
Family Medicine
301 WILLIAMSTON CENTER RD
Williamston, MI 48895
  • Reassigned Medicare billing, Michigan enrollment
  • Also billed through NPI 1437331501 (Michigan), NPI 1689683641 (Michigan)
  • 14 clinicians in this Medicare group
NPI 1205285335 (517) 253-5125

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 7

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.

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.
85 services63 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.
23 services22 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.
22 services17 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
18 services18 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.
13 services13 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

St Joe Mercy Hospital System Livonia

Acute Care Hospitals · Livonia, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230002
Location36475 Five Mile RoadLivonia, MI 48154 · Wayne County
Emergency services Birthing friendly

University Of Michigan Health System

Acute Care Hospitals · Ann Arbor, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230046
Location1500 E Medical Center Drive, Spc 5474Ann Arbor, MI 48109 · Washtenaw County
Emergency services Birthing friendly

Saint Joseph Mercy Livingston Hospital

Acute Care Hospitals · Howell, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230069
Location620 Byron RdHowell, MI 48843 · Livingston County
Emergency services

Trinity Health Ann Arbor Hospital

Acute Care Hospitals · Ann Arbor, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230156
Location5301 E Huron River DrAnn Arbor, MI 48106 · Washtenaw County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48116 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
33%137 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
84%153 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers17 claims33 services$6.52 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$91.17 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Dorothea Edmunds's NPI number?

The NPI number for Dorothea Edmunds is 1982979449. It was assigned to this individual provider in the NPPES registry on March 16, 2012. The provider is also known as Dorothea Guilfoyle D.O..

Where is Dorothea Edmunds located?

Dorothea Edmunds practices at Iha Primary Care East Brighton 5505 S. Old Us 23 Ste 100, Brighton, MI 48116. The listed phone number is (810) 494-6885.

What is Dorothea Edmunds's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Dorothea Edmunds enrolled in Medicare?

Yes. Dorothea Edmunds 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 Dorothea Edmunds's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dorothea Edmunds reassigns Medicare benefits to 2 organizations: Iha Health Services Corporation (Brighton, MI) and Edward W. Sparrow Hospital Association (Williamston, 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 Dorothea Edmunds's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dorothea Edmunds 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 Dorothea Edmunds 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 Dorothea Edmunds affiliated with any hospitals?

According to CMS data, Dorothea Edmunds is affiliated with St Joe Mercy Hospital System Livonia, University Of Michigan Health System, Saint Joseph Mercy Livingston Hospital and Trinity Health Ann Arbor Hospital.

When was this NPI record last updated?

The NPPES record for Dorothea Edmunds was last updated on June 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.