NPIMap

Individual provider Active NPI

Mark Dukaj, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1285636639
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD055760 Issued in MI
Practice address
22201 Moross Rd
Ste 150
Detroit, MI 48236-2169
Phone
(313) 886-8787
Fax
(313) 886-4103
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Cornerstone Medical Group 65 clinicians

Practice addresses (Care Compare)

45640 Schoenherr Rd
Shelby Township, MI 48315-6033
Phone (586) 566-3092

Hospital & facility affiliations

  • Activ-Care Home Health Services, Inc Home health agency, Warren, MI, CCN 237645
  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Henry Ford Home Health Care Home health agency, Detroit, MI, CCN 237087
  • Beaumont Home Health Home health agency, Troy, MI, CCN 237112
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091019000073 MI Practitioner - Internal Medicine 8527017680 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD055760MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group CurrentSince Jan 1, 2016 Accepting new patients
St Clair Specialty Physicians PC Current Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

4260 Van Dyke Rd
Ste 10
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

22201 Moross Rd
Ste 150
Grosse Pointe, MI 48236
Phone (313) 343-7110

20952 E 12 Mile Rd
Ste 100
Saint Clair Shores, MI 48081
Phone (586) 498-3550

23857 Greenfield Rd
Southfield, MI 48075
Phone (248) 569-6111

45640 Schoenherr Rd
Ste B
Utica, MI 48315
Phone (586) 247-4300

45660 Schoenherr Rd
Utica, MI 48315
Phone (586) 566-3020

45640 Schoenherr Rd
Utica, MI 48315
Phone (586) 247-4300

Interoperability endpoints

  • Direct secure messaging: mark.dukaj.2@8209.direct.athenahealth.com
  • Direct secure messaging: mdukaj1049710@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD055760 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

22201 Moross Rd
Ste 150
Detroit, MI 48236-2169

Mailing address

45640 Schoenherr Rd
Ste 150
Shelby Township, MI 48315-6033
Phone (586) 566-3092

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2016.

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1285636639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45640 SCHOENHERR RD",
            "address_2": "STE 150",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483156033",
            "telephone_number": "586-566-3092",
            "fax_number": "586-566-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "STE 150",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-886-8787",
            "fax_number": "313-886-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKAJ",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "MD055760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.