Imelda E De Vera, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

5101018657 Issued in MI

Practice address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Phone

(248) 898-5000

NPI assigned

Mar 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Anesthesiology

Education

Michigan State University College of Osteopathic Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Anesthesia PLLCGroup PAC ID 4789096942, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Paragon Anesthesia PLLC

  • Anesthesiology Physician
  • Birmingham, MI
  • NPI 1356940670
  Medicare reassignment Care Compare group NPD
• Long Lake Anesthesiology Consultants, PLC

  • Anesthesiology Physician
  • Troy, MI
  • NPI 1194812651
  Medicare reassignment NPD
• Northland Anesthesia Associates, PC

  • Anesthesiology Physician
  • Southfield, MI
  • NPI 1528001880
  Medicare reassignment NPD
• Nsa Pain Services of Michigan III, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Taylor, MI
  • NPI 1376169524
  Medicare reassignment NPD
• Providence Park Anesthesia Associates, PC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1942459672
  Medicare reassignment NPD
• Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
  • NPI 1972126209

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1285958736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843510",
            "telephone_number": "248-458-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "IMELDA",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101018657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DCP of Michigan (Troy), P.C.
• Sean Joseph De Four, M.S.W., L.M.S.W.
• Kristen De Long
• Leticia De Mattei, M.D.
• Paulo Vinicius De Oliveira, OTRL
• Larissa Dean, MD
• Rachel Dearden, MD
• Deborah McMillan
• Kristin Jo Debruin, PA-C
• Cynthia K Decker, NP

• Anesthesiology Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.