Active NPI
John David Fisher, PA-C
- Physician Assistant
- Detroit, MI
National Provider Identifier
1225753775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4001 W McNichols Rd
Detroit, MI 48221-3038 - Phone
- (313) 993-1245
- NPI assigned
- Oct 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4001 W McNichols Rd
Detroit, MI 48221-3038
Mailing address
417 Kerby Rd
Grosse Pointe Farms, MI 48236-2921
Phone (313) 283-9317
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1131 M 32
Alpena, MI 49707-8222
Phone (989) 250-1925
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Urgent Care of Michigan, PC | Current | Accepting new patients | |
| Hometown Urgent Care of Michigan, P.C. | Current | Accepting new patients | |
| Hometown Urgent Care of Michigan, P.C. | Current | Accepting new patients | |
| University of Detroit Mercy | Past | Accepting new patients |
Locations
1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925
1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835
Organizations & group practices 5
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.
-
- Urgent Care Clinic/Center
- Huber Heights, OH
- NPI 1790030385
MI
-
- Clinical Medical Laboratory
- Kalamazoo, MI
- NPI 1891469631
-
- Clinical Medical Laboratory
- Indianapolis, IN
- NPI 1881358489
-
- General Practice Physician
- Detroit, MI
- NPI 1669187696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1225753775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 KERBY RD",
"city": "GROSSE POINTE FARMS",
"state": "MI",
"postal_code": "482362921",
"telephone_number": "313-283-9317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 W MCNICHOLS RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482213038",
"telephone_number": "313-993-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "JOHN",
"middle_name": "DAVID",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-06",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.