Individual provider Active NPI

Ted H Schwartzenfeld, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Madison Heights, MI
National Provider Identifier
1124007539
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
5101006332 Issued in MI
Practice address
27483 Dequindre Rd Ste 201
Madison Heights, MI 48071-5711
Phone
(248) 541-0100
Fax
(248) 399-3960
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101006332 MI Primary

Addresses

Primary practice location

27483 Dequindre Rd Ste 201
Madison Heights, MI 48071-5711

Mailing address

27483 Dequindre Rd Ste 201
Madison Heights, MI 48071-5711
Phone (248) 541-0100

Other identifiers 4

IdentifierTypeStateIssuer
4170644MedicaidMI
4170653MedicaidMI
4170662MedicaidMI
4343620MedicaidMI

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
I20050412000218 MI Practitioner - Otolaryngology 3577500560 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101006332MIMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Jan 1, 2013 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Jan 1, 2013 Accepting new patients
David Schwartzenfeld Medical PC CurrentSince Feb 28, 2019 Accepting new patients
ENT Surgical Assoc PC Otolaryngology/Facial Plastic Surgery Past Accepting new patients

Locations

6825 Allen Rd
Allen Park, MI 48101

28080 Grand River Ave
Ste 205W
Farmington Hills, MI 48336
Phone (248) 478-8616

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27483 Dequindre Rd
Ste 201
Madison Hts, MI 48071
Phone (248) 541-0100

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

8790 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-2520

28295 Schoenherr Rd
Ste B
Warren, MI 48088
Phone (586) 226-6120

Interoperability endpoints

  • Direct secure messaging: ted.schwartzenfeld.1@14250.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1124007539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27483 DEQUINDRE RD STE 201",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480715711",
            "telephone_number": "248-541-0100",
            "fax_number": "248-399-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27483 DEQUINDRE RD STE 201",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480715711",
            "telephone_number": "248-541-0100",
            "fax_number": "248-399-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZENFELD",
        "first_name": "TED",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101006332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4170644",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4170653",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4170662",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4343620",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

Verify at the official NPI Registry.