Individual provider Active NPI

David M. Mowery, PA

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1255577474
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601005421 Issued in MI
Practice address
3901 Beaubien St
2ND Floor Carl'S BLDG
Detroit, MI 48201-2119
Phone
(313) 745-5541
Fax
(313) 993-2948
NPI assigned
Dec 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601005421 MI Primary

Addresses

Primary practice location

3901 Beaubien St
2ND Floor Carl'S BLDG
Detroit, MI 48201-2119

Mailing address

4201 Saint Antoine St
Uhc - 5D Mailbox #226
Detroit, MI 48201-2153
Phone (313) 745-4405

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000515 MI Practitioner - Physician Assistant 8729143672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Mar 26, 2018 Accepting new patients
University Pediatricians CurrentSince Mar 26, 2018 Accepting new patients
Hurley Medical Center Past Accepting new patients
Hurley Medical Center Past Accepting new patients

Locations

3901 Beaubien St
Fl 2
Detroit, MI 48201
Phone (313) 745-0659

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3901 Beaubien St
Fl 5
Detroit, MI 48201
Phone (313) 745-4000

Interoperability endpoints

  • Direct secure messaging: dmowery@direct.dmc.org
  • Direct secure messaging: dmowery24343@direct.hurleymc.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1255577474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "UHC - 5D MAILBOX #226",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "address_2": "2ND FLOOR CARL'S BLDG",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5541",
            "fax_number": "313-993-2948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWERY",
        "first_name": "DAVID",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-17",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.