Anthony Bozaan III, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301088907 Issued in MI

Practice address

2305 Genoa Business Park Dr
Ste 230
Brighton, MI 48114-7004

Phone

(810) 494-6881

Fax

(810) 494-6882

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

General Surgery

Education

Michigan State University College of Human Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  dba IHA Colon & Rectal Surgery

  • Colon & Rectal Surgery Physician
  • Ypsilanti, MI
  • NPI 1598006074
  NPD
• Iha Health Services Corporation

  dba IHA Plymouth Primary Care

  • Internal Medicine Physician
  • Plymouth, MI
  • NPI 1912184201
  NPD (past)

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

• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1043257959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "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": "2305 GENOA BUSINESS PARK DR",
            "address_2": "STE 230",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147004",
            "telephone_number": "810-494-6881",
            "fax_number": "810-494-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZAAN",
        "first_name": "ANTHONY",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35081878",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301088907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Boucher, CPNP-PC
• Joseph Bourdages
• Kelly Bowers, PHD
• Rita Gail Bowman, M.A., CCC-SLP
• Dayna Boyle, L.M.S.W.
• Katherine Braciszewski, RN, BSN
• Moriah Brackett, BCBA
• Brad L. Rondeau, DDS, PC
• Jennifer G Bradley, CCC
• Jessica Bradley

• Surgery Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.