Individual provider Active NPI

John David Denzin, MD

  • Orthopaedic Surgery Physician
  • Ypsilanti, MI
National Provider Identifier
1013999713
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301033966 Issued in MI
Practice address
5315 Elliott Dr
Suite 304
Ypsilanti, MI 48197-8634
Phone
(734) 712-0655
Fax
(734) 712-0611
NPI assigned
Nov 17, 2005
Last updated
Apr 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301033966 MI Primary

Addresses

Primary practice location

5315 Elliott Dr
Suite 304
Ypsilanti, MI 48197-8634

Mailing address

PO Box 0446 24 Frank Lloyd Wright Dr. Lobby J
Iha
Ann Arbor, MI 48106
Phone (734) 747-6766

Other identifiers 3

IdentifierTypeStateIssuer
2008154942OtherMIBLUE CROSS BLUE SHIELD
4774280MedicaidMI
101582OtherMICARE CHOICES

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
I20050825000957 MI Practitioner - Orthopedic Surgery 4284530668 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Orthopaedic Surgery CurrentSince Mar 6, 2016 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Mar 6, 2016 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5315 Elliott Dr
Ste 304
Ypsilanti, MI 48197
Phone (734) 712-0655

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1013999713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0446 24 FRANK LLOYD WRIGHT DR. LOBBY J",
            "address_2": "IHA",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48106",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR",
            "address_2": "SUITE 304",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-712-0655",
            "fax_number": "734-712-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENZIN",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301033966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2008154942",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4774280",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "101582",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.