Individual provider Active NPI

Evan Bischoff, DO

  • Family Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1245079151
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5151016902 Issued in MI
Practice address
1 Genesys Pkwy
Ascension Genesys Hosp
Grand Blanc, MI 48439-1477
Phone
(810) 606-5636
NPI assigned
May 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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 5151016902 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Ascension Genesys Hosp
Grand Blanc, MI 48439-1477

Mailing address

1 Genesys Pkwy
Ascension Genesys Hosp
Grand Blanc, MI 48439-1477
Phone (810) 606-5636

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
I20240819000375 MI Order and Referring Only - Family PracticePractitioner - Family Practice 1052859352

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151016902MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1245079151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "ASCENSION GENESYS HOSP",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391477",
            "telephone_number": "810-606-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "ASCENSION GENESYS HOSP",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391477",
            "telephone_number": "810-606-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISCHOFF",
        "first_name": "EVAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151016902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.