Active NPI
John Efthyvoulidis
- Family Medicine Physician
- Clinton Township, MI
National Provider Identifier
1194352815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5151014423
- Practice address
- 15855 19 Mile Rd
Clinton Township, MI 48038-3504 - Phone
- (586) 263-2300
- NPI assigned
- Mar 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5151014423 | MI | Primary |
Addresses
Primary practice location
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Mailing address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jefthyvoulidis529907@direct.hfhs.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1349 S Rochester Rd
Suite 100
Rochester Hills, MI 48307-3151
Phone (248) 759-5460
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ram Surendran M.D. PC | Family Medicine | Current | Accepting new patients |
Locations
1349 S Rochester Rd
Ste 100
Rochester Hills, MI 48307
Phone (248) 759-5460
1349 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 391-0900
Interoperability endpoints
- jefthyvoulidis529907@direct.hfhs.org
- john.efthyvoulidis.1@9152.direct.athenahealth.com
- https://api.platform.athenahealth.com/9152/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Rochester Hills, MI
- NPI 1861419681
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Rochester, MI
- NPI 1437176203
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1194352815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480383504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480383504",
"telephone_number": "586-263-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EFTHYVOULIDIS",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-24",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5151014423",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jefthyvoulidis529907@direct.hfhs.org",
"affiliation": "N",
"address_1": "15855 19 Mile Rd",
"city": "Clinton Township",
"state": "MI",
"country_code": "US",
"postal_code": "480383504",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.