Shelbydale Medical Clinic, P.c. - Medicare Primary Care in Shelby Twp, MI

Shelbydale Medical Clinic, P.c. is a medicare enrolled primary clinic (Family Medicine) in Shelby Twp, Michigan. The current practice location for Shelbydale Medical Clinic, P.c. is 49221 Van Dyke Ave, Shelby Twp, Michigan. For appointments, you can reach them via phone at (586) 254-4860. The mailing address for Shelbydale Medical Clinic, P.c. is 49221 Van Dyke Ave, Shelby Twp, Michigan and phone number is (586) 254-4860.

Shelbydale Medical Clinic, P.c. is licensed to practice in Michigan (license number KT008999). The clinic also participates in the medicare program and its NPI number is 1629258488. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (586) 254-4860.

Contact Information

Shelbydale Medical Clinic, P.c.
49221 Van Dyke Ave
Shelby Twp
MI 48317-1336
(586) 254-4860
(586) 254-5844

Map and Direction


Primary Care Clinic Profile

Full NameShelbydale Medical Clinic, P.c.
SpecialityFamily Medicine
Location49221 Van Dyke Ave, Shelby Twp, Michigan
Authorized Official Name and PositionKeith B Tom (PRESIDENT)
Authorized Official Contact5862544860
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Shelbydale Medical Clinic, P.c.
49221 Van Dyke Ave
Shelby Twp
MI 48317-1336

Ph: (586) 254-4860
Shelbydale Medical Clinic, P.c.
49221 Van Dyke Ave
Shelby Twp
MI 48317-1336

Ph: (586) 254-4860

NPI Details:

NPI Number1629258488
Provider Enumeration Date11/09/2007
Last Update Date11/09/2007

Medicare PECOS Information:

Medicare PECOS PAC ID4880651405
Medicare Enrollment IDO20041215000750

Medical Identifiers

Medical identifiers for Shelbydale Medical Clinic, P.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629258488NPI-NPPES
2646558MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine KT008999 (Michigan)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Shelbydale Medical Clinic, P.c. acts as a billing entity for following providers:
Provider NameKeith Brian Tom
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1609850130
PECOS PAC ID: 1052378676
Enrollment ID: I20041215000775

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.