Individual provider Active NPI

David M. Ozog, M.D.

  • MOHS-Micrographic Surgery Physician
  • Detroit, MI
National Provider Identifier
1083792113
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
4301076533 Issued in MI
Practice address
3031 W Grand Blvd
Detroit, MI 48202-3046
Phone
(313) 916-2454
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4301076533 MI
MOHS-Micrographic Surgery Physician 207ND0101X 4301076533 MI Primary
Procedural Dermatology Physician 207NS0135X 4301076533 MI

Addresses

Primary practice location

3031 W Grand Blvd
Detroit, MI 48202-3046

Mailing address

3031 W Grand Blvd
Detroit, MI 48202-3046
Phone (313) 916-2454

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
I20040816000259 MI Practitioner - Dermatology 4486627742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Rochester School of Medicine and Dentistry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 876-2151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions12
Removal of skin cancer304
Skin biopsy16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jul 1, 2004 Accepting new patients
Henry Ford Health System Dermatology CurrentSince Jul 1, 2004 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

3031 W Grand Blvd
Detroit, MI 48202
Phone (313) 871-3751

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

6530 Farmington Rd
West Bloomfield, MI 48322
Phone (248) 451-6010

Interoperability endpoints

  • Direct secure messaging: david.ozog.1@18430.direct.athenahealth.com
  • Direct secure messaging: dozog13337@direct.hfhs.org

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1083792113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023046",
            "telephone_number": "313-916-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023046",
            "telephone_number": "313-916-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZOG",
        "first_name": "DAVID",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301076533",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "4301076533",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MI",
            "license": "4301076533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.