Blue Water Internal Medicine, PC
NPI 1255967667 · Internal Medicine Physician · Port Huron, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Blue Water Internal Medicine, PC is a Internal Medicine Physician organization in Port Huron, MI (NPI 1255967667).
Provider details
- NPI number
- 1255967667
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nikki Hack, Practice Manager(810) 662-3505
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-03-17
- Last updated
- 2024-11-18
- Certified
- 2024-11-18
Frequently asked questions
- What is Blue Water Internal Medicine, PC's NPI number?
- Blue Water Internal Medicine, PC's National Provider Identifier (NPI) is 1255967667, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blue Water Internal Medicine, PC?
- Blue Water Internal Medicine, PC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Blue Water Internal Medicine, PC located?
- Blue Water Internal Medicine, PC's practice location on file with NPPES is 1210 10th Ave, Port Huron, MI 48060-3406.
- What is Blue Water Internal Medicine, PC's phone number?
- The practice phone number listed in the NPPES registry for Blue Water Internal Medicine, PC is (810) 622-3505.
- Does Blue Water Internal Medicine, PC accept Medicare?
- Blue Water Internal Medicine, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Blue Water Internal Medicine, PC?
- The authorized official listed on Blue Water Internal Medicine, PC's NPPES record is Nikki Hack, Practice Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blue Water Internal Medicine, PC's NPI active?
- Yes — Blue Water Internal Medicine, PC's NPI (1255967667) is active in the NPPES registry as of the last update on 2024-11-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.