Active NPI
Trevor Eckenswiller, DO
- Emergency Medicine Physician
- Troy, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101025479
- Practice address
- 44201 Dequindre Rd
Troy, MI 48085-1117 - Phone
- (248) 964-5111
- Fax
- (248) 964-5068
- NPI assigned
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101025479 | MI | Primary |
Addresses
Primary practice location
44201 Dequindre Rd
Troy, MI 48085-1117
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Other practice location 1
36555 26 Mile Rd Ste 1100
Lenox, MI 48048-3186
Phone (947) 523-4040
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | teckenswiller461108@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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187
44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111
Hospital & facility affiliations
- Beaumont Hospital, Troy
- McLaren Bay Region
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101025479 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group Hospital -Based Services | Current | Accepting new patients | |
| McLaren Hospital Group | Emergency Medicine | Current | Accepting new patients |
Locations
1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000
401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000
36555 26 Mile Rd
Ste 1100
Lenox, MI 48048
Phone (947) 523-4010
50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300
3601 W 13 Mile Rd
Royal Oak, MI 48073
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
Interoperability endpoints
- teckenswiller1232282@epic00.shdirect.org
- teckenswiller461108@direct.beaumont.edu
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.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
-
- Emergency Medicine Physician
- Flint, MI
- NPI 1942026174
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bay City, MI
- NPI 1528031226
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1316477268",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44201 DEQUINDRE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480851117",
"telephone_number": "248-964-5111",
"fax_number": "248-964-5068"
}
],
"practiceLocations": [
{
"address_1": "36555 26 Mile Rd Ste 1100",
"address_purpose": "LOCATION",
"city": "Lenox",
"state": "MI",
"postal_code": "480483186",
"country_code": "US",
"telephone_number": "947-523-4040",
"fax_number": "947-523-4011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ECKENSWILLER",
"first_name": "TREVOR",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-14",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101025479",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "teckenswiller461108@direct.beaumont.edu",
"affiliation": "N",
"address_1": "44201 Dequindre Rd",
"city": "Troy",
"state": "MI",
"country_code": "US",
"postal_code": "480851117",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.