Organization Active NPI

John S Demare DO PC

  • Family Medicine Physician
  • Sterling Heights, MI
National Provider Identifier
1063527901
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHN S DEMARE DO PC
Practice address
13700 19 Mile Rd
Sterling Heights, MI 48313-2702
Phone
(586) 247-6020
Fax
(586) 247-7048
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Linda J Kenny
Title
Office Manager
Phone
(586) 247-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

13700 19 Mile Rd
Sterling Heights, MI 48313-2702

Mailing address

13700 19 Mile Rd
Sterling Heights, MI 48313-2702
Phone (586) 247-6020

Other identifiers 1

IdentifierTypeStateIssuer
0E01378OtherBX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040501000400 MI Part B Supplier - Clinic/Group Practice 5698763480 Receives reassigned benefits from 8 practitioners
Practice locations: Sterling Heights, MI

National Provider Directory

National Provider Directory

Locations

13700 19 Mile Rd
Sterling Hts, MI 48313
Phone (586) 247-6020

Practitioners & affiliated clinicians

Practitioners 8

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1063527901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 19 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132702",
            "telephone_number": "586-247-6020",
            "fax_number": "586-247-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 19 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132702",
            "telephone_number": "586-247-6020",
            "fax_number": "586-247-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S DEMARE DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "KENNY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-247-6020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX",
            "identifier": "0E01378",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.