Individual provider Active NPI

Gary S Kwartowitz, D.O.

  • Otolaryngology Physician
  • Clarkston, MI
National Provider Identifier
1003924820
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
GK012039 Issued in MI
Practice address
5701 Bow Pointe Dr
Suite 200
Clarkston, MI 48346-3198
Phone
(248) 620-3100
Fax
(248) 620-3019
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X GK012039 MI Primary

Addresses

Primary practice location

5701 Bow Pointe Dr
Suite 200
Clarkston, MI 48346-3198

Mailing address

5701 Bow Pointe Dr
Suite 200
Clarkston, MI 48346-3198
Phone (248) 620-3100

Other identifiers 1

IdentifierTypeStateIssuer
3477100MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090128000440 MI Practitioner - Otolaryngology 2062573942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Oakland Ear Nose and Throat Centers PCGroup PAC ID 6800879461, 3 clinicians

Practice addresses (Care Compare)

5701 Bow Pointe Dr
Suite 200
Clarkston, MI 48346-5400
Phone (248) 620-3100

Hospital & facility affiliations

  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
GK012039MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Oakland Ear Nose &Throat Centers PC Otolaryngology CurrentSince Oct 13, 2008 Accepting new patients

Locations

5701 Bow Pointe Dr
Ste 200
Clarkston, MI 48346
Phone (248) 620-3100

951 S Main St
Ste 2
Lapeer, MI 48446
Phone (810) 664-4479

Interoperability endpoints

  • Direct secure messaging: garykwartowitz@noentc.allscriptsdirect.net
  • Direct secure messaging: gkwartowitz1135516@direct.hfhs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1003924820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR",
            "address_2": "SUITE 200",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463198",
            "telephone_number": "248-620-3100",
            "fax_number": "248-620-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR",
            "address_2": "SUITE 200",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463198",
            "telephone_number": "248-620-3100",
            "fax_number": "248-620-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWARTOWITZ",
        "first_name": "GARY",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "GK012039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3477100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.