NPIMap

Individual provider Active NPI

Eytan Keidar, D.O.

  • Otolaryngology Physician
  • Novi, MI
National Provider Identifier
1053846238
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
5101023492 Issued in MI
Practice address
25500 Meadowbrook Rd Ste 220
Novi, MI 48375-1882
Phone
(248) 477-7020
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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 5101023492 MI Primary

Addresses

Primary practice location

25500 Meadowbrook Rd Ste 220
Novi, MI 48375-1882

Mailing address

25500 Meadowbrook Rd Ste 220
Novi, MI 48375-1882
Phone (248) 477-7020

Other practice location 1

6249 Grand River Rd
Brighton, MI 48114-5305
Phone (810) 844-1900

Other practice location 2

31100 Telegraph Rd Ste 230
Bingham Farms, MI 48025-4347
Phone (248) 453-6079

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eytan.keidar.1@2309.direct.athenahealth.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706003704 MI Practitioner - Otolaryngology 0941570006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
ENT Specialists PCGroup PAC ID 0648370874, 13 clinicians

Practice addresses (Care Compare)

25500 Meadowbrook Rd
Suite 220
Novi, MI 48375-1882
Phone (248) 477-7020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.99 of 100Reported as group
Quality
75.61
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2309/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ekeidar421283@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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1053846238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 220",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751882",
            "telephone_number": "248-477-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 220",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751882",
            "telephone_number": "248-477-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6249 Grand River Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481145305",
            "country_code": "US",
            "telephone_number": "810-844-1900",
            "fax_number": "810-844-1981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31100 Telegraph Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Bingham Farms",
            "state": "MI",
            "postal_code": "480254347",
            "country_code": "US",
            "telephone_number": "248-453-6079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEIDAR",
        "first_name": "EYTAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "5101023492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eytan.keidar.1@2309.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "25500 Meadowbrook Rd Ste 220",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483751882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.