Individual provider Active NPI

Martin Irvin Schock, MD

  • Hematology & Oncology Physician
  • Warren, MI
National Provider Identifier
1063478428
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301027896 Issued in MI
Practice address
11885 E 12 Mile Rd
Suite 100a
Warren, MI 48093-3474
Phone
(586) 576-1615
Fax
(586) 576-1628
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4301027896 MI Primary

Addresses

Primary practice location

11885 E 12 Mile Rd
Suite 100a
Warren, MI 48093-3474

Mailing address

11885 E 12 Mile Rd
Suite 100a
Warren, MI 48093-3474
Phone (586) 576-1615

Other identifiers 1

IdentifierTypeStateIssuer
1405362MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1063478428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD",
            "address_2": "SUITE 100A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933474",
            "telephone_number": "586-576-1615",
            "fax_number": "586-576-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD",
            "address_2": "SUITE 100A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933474",
            "telephone_number": "586-576-1615",
            "fax_number": "586-576-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOCK",
        "first_name": "MARTIN",
        "middle_name": "IRVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301027896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1405362",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.