| Ryan James Nelson, DO | |
|
11051 Hall Rd Ste 200, Utica, MI 48317-5742 | |
| (586) 254-5759 | |
| (586) 254-5793 |
| Full Name | Ryan James Nelson |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 17 Years |
| Location | 11051 Hall Rd Ste 200, Utica, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194955831 | NPI | - | NPPES |
| 0E06273 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 5101018425 (Michigan) | Secondary |
| 208800000X | Urology | 5101018424 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Henry Ford Macomb Hospital | Clinton township, MI | Hospital |
| Beaumont Hospital, Troy | Troy, MI | Hospital |
| Beaumont Hospital - Grosse Pointe | Grosse pointe, MI | Hospital |
| Mclaren Macomb | Mount clemens, MI | Hospital |
| Beaumont Hospital Royal Oak | Royal oak, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Michigan Institute Of Urology Pc | 1052223492 | 77 |
| Mclaren Macomb | 8921912791 | 114 |
| Entity Name | Michigan Institute Of Urology Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427027416 PECOS PAC ID: 1052223492 Enrollment ID: O20031125000770 |
| Entity Name | Mclaren Macomb |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396014601 PECOS PAC ID: 8921912791 Enrollment ID: O20040120001000 |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan James Nelson, DO 20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081-3203 Ph: (586) 771-4820 | Ryan James Nelson, DO 11051 Hall Rd Ste 200, Utica, MI 48317-5742 Ph: (586) 254-5759 |
John R Harding, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 11051 Hall Rd, Suite 200, Utica, MI 48317 Phone: 586-254-5759 Fax: 586-254-5793 | |
Earl R Koenig, MD Urology Medicare: Medicare Enrolled Practice Location: 11051 Hall Rd, Suite 200, Utica, MI 48317 Phone: 586-254-5759 Fax: 586-254-5793 |