Organization Active NPI

North Oakland Ear Nose &Throat Centers PC

  • Otolaryngology Physician
  • Clarkston, MI
National Provider Identifier
1013026855
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
NORTH OAKLAND EAR NOSE &THROAT CENTERS PC
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Authorized official

Name
Carl Shermetaro, D.O.NPI 1700994530
Title
President
Phone
(248) 620-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 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 2

IdentifierTypeStateIssuer
1013026855MedicaidMI
040F374250OtherMIBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL noent@comcast.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040612000587 MI Part B Supplier - Clinic/Group Practice 6800879461 Receives reassigned benefits from 3 practitioners
Practice locations: Clarkston, MI; Lapeer, MI; Rochester Hills, MI

National Provider Directory

National Provider Directory

Locations

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

6770 Dixie Hwy
Ste 302
Clarkston, MI 48346
Phone (248) 620-3100

951 S Main St
Ste 200
Lapeer, MI 48446

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1013026855",
    "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": {
        "organization_name": "NORTH OAKLAND EAR NOSE &THROAT CENTERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "SHERMETARO",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-620-3100",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013026855",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "040F374250",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "noent@comcast.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5701 Bow Pointe Dr",
            "address_2": "Suite 200",
            "city": "Clarkston",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483463198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.