Individual provider Active NPI

Dominic James Maffetone, MD

  • Family Medicine Physician
  • Farmington, MI
National Provider Identifier
1164950341
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301501877 Issued in MI
Practice address
23133 Orchard Lake Rd Ste 102
Farmington, MI 48336-3278
Phone
(248) 476-2420
NPI assigned
Jun 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301501877 MI Primary

Addresses

Primary practice location

23133 Orchard Lake Rd Ste 102
Farmington, MI 48336-3278

Mailing address

6379 Silver Lake Rd
Linden, MI 48451-8706
Phone (810) 735-7847

Other practice location 1

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5000

Other practice location 2

6379 Silver Lake Rd
Linden, MI 48451-8706
Phone (810) 735-7847

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
I20200803003165 MI Practitioner - Family Practice 4486925559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PC 63 clinicians

Practice addresses (Care Compare)

23133 Orchard Lake Rd
Suite 102
Farmington, MI 48336-3278
Phone (248) 476-2420

Hospital & facility affiliations

  • Tone Home Health Services Home health agency, Farmington Hills, MI, CCN 237634

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Eastern Michigan, PC Family Medicine CurrentSince Feb 1, 2025 Accepting new patients
Genesys Integrated Group Practice PC Past Accepting new patients

Locations

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

Interoperability endpoints

  • Direct secure messaging: dominic.maffetone.1@21803.direct.athenahealth.com

Organizations & group practices 2

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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1164950341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6379 SILVER LAKE RD",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518706",
            "telephone_number": "810-735-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23133 ORCHARD LAKE RD STE 102",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363278",
            "telephone_number": "248-476-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Genesys Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484398065",
            "country_code": "US",
            "telephone_number": "810-606-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6379 Silver Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Linden",
            "state": "MI",
            "postal_code": "484518706",
            "country_code": "US",
            "telephone_number": "810-735-7847",
            "fax_number": "810-249-4312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAFFETONE",
        "first_name": "DOMINIC",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301501877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MI

Sources for this page

Verify at the official NPI Registry.