Individual provider Active NPI

Dushan Nestor, MD

  • Family Medicine Physician
  • Troy, MI
National Provider Identifier
1235120569
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301044600 Issued in MI
Practice address
2888 E Long Lake Rd
Ste 105
Troy, MI 48085-3793
Phone
(248) 689-1330
Fax
(248) 689-6424
NPI assigned
Nov 4, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301044600 MI Primary
Family Medicine Physician 207Q00000X ME 56924 FL

Addresses

Primary practice location

2888 E Long Lake Rd
Ste 105
Troy, MI 48085-3793

Mailing address

2888 E Long Lake Rd
Ste 105
Troy, MI 48085-3793
Phone (248) 689-1330

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
I20150218001663 MI Order and Referring Only - Family PracticePractitioner - Family Practice 3274858097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 56924FLMDFamily Medicine Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235120569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 E LONG LAKE RD",
            "address_2": "STE 105",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853793",
            "telephone_number": "248-689-1330",
            "fax_number": "248-689-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 E LONG LAKE RD",
            "address_2": "STE 105",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853793",
            "telephone_number": "248-689-1330",
            "fax_number": "248-689-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTOR",
        "first_name": "DUSHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301044600",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 56924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.