Individual provider Active NPI

Daniel Edison Zoller, M.D.

  • Pediatrics Physician
  • Farmington Hills, MI
National Provider Identifier
1245431212
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301084342 Issued in MI
Practice address
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone
(947) 521-8000
NPI assigned
May 29, 2007
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301084342 MI Primary

Addresses

Primary practice location

28050 Grand River Ave
Farmington Hills, MI 48336-5919

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1865

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-3284

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dzoller95992@direct.beaumont.edu

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
I20090202000559 MI Practitioner - Pediatric Medicine 7810051042 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Dec 2, 2019 Accepting new patients
Henry Ford Macomb Hospital Corporation Pediatrics CurrentSince Dec 2, 2019 Accepting new patients
Botsford General Hospital Pediatrics CurrentSince Jul 31, 2010 Accepting new patients
Botsford General Hospital CurrentSince Jul 31, 2010 Accepting new patients
Botsford General Hospital Past Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2373

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

32754 Grand River Ave
Farmington Hls, MI 48336
Phone (248) 476-3280

3601 W 13 Mile Rd
Royal Oak, MI 48073

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: dzoller1263250@epic00.shdirect.org
  • Direct secure messaging: dzoller95992@direct.beaumont.edu

Organizations & group practices 6

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1245431212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28050 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365919",
            "telephone_number": "947-521-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-3284",
            "fax_number": "248-898-9189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOLLER",
        "first_name": "DANIEL",
        "middle_name": "EDISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301084342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dzoller95992@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "28050 Grand River Ave",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.