Jeffrey Louis Provizer, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101013058 Issued in MI

Practice address

32255 Northwestern Hwy Ste 130
Farmington Hills, MI 48334

Phone

(248) 723-5880

Fax

(248) 723-5889

NPI assigned

Sep 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Family Practice

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Optimal Care Home Health Home health agency, Bingham Farms, MI, CCN 237504
• Beaumont Home Health Home health agency, Troy, MI, CCN 237112
• The Medical Team Inc Hospice, Livonia, MI, CCN 231645
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jprovizer63367@direct.hfhs.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The Medical Team, Inc.

  • Community Based Hospice Care Agency
  • Livonia, MI
  • NPI 1164823001

  Contracted Managing Employee

  CMS ownership

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.

• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Beaumont Ashn, LLC

  dba Beaumont Home Health and Hospice, LLC

  • Home Health Agency
  • Troy, MI
  • NPI 1811461734
  Care Compare affiliation
• Botsford General Hospital

  • Podiatrist
  • Farmington Hills, MI
  • NPI 1093828303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Dearborn Heights, MI
  • NPI 1114935566

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  dba Beaumont Hospital-Farmington Hills

  • General Acute Care Hospital
  • Farmington Hills, MI
  • NPI 1336183367
  Care Compare affiliation
• Botsford General Hospital

  dba Internal Medicine Associates Farmington Hills

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1538103395

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Farmington Hills, MI
  • NPI 1871521153

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1871907303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  dba Botsford Thoracic Surgery Clinic

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1912335373

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Pulmonary Disease Physician
  • Farmington Hills, MI
  • NPI 1912915349

  Hospital

  Care Compare affiliation
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• Optimal Care, LLC

  dba Optimal Care Home Health

  • Home Health Agency
  • Bingham Farms, MI
  • NPI 1588697841
  Care Compare affiliation
• The Medical Team, Inc.

  • Community Based Hospice Care Agency
  • Livonia, MI
  • NPI 1164823001
  Care Compare affiliation

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1316931405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32255 NORTHWESTERN HWY STE 130",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-723-5880",
            "fax_number": "248-723-5889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N Pontiac Trl",
            "address_purpose": "LOCATION",
            "city": "Walled Lake",
            "state": "MI",
            "postal_code": "483903443",
            "country_code": "US",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4123 Martin Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Commerce Twp",
            "state": "MI",
            "postal_code": "483904151",
            "country_code": "US",
            "telephone_number": "248-366-3700",
            "fax_number": "248-360-1760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 N Pontiac Trl",
            "address_purpose": "LOCATION",
            "city": "Walled Lake",
            "state": "MI",
            "postal_code": "483903443",
            "country_code": "US",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 N Pontiac Trl",
            "address_purpose": "LOCATION",
            "city": "Walled Lake",
            "state": "MI",
            "postal_code": "483903443",
            "country_code": "US",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVIZER",
        "first_name": "JEFFREY",
        "middle_name": "LOUIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316931405",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Proulx
• Amanda Provencher
• Tara Provencher
• Provider Services Network LLC
• Provider Wellness Group, LLC
• Kari K Provizer, LMSW, ACSW
• Noah Provizer, DDS
• Sebra Provost
• Mechele Prowell
• Kaylynn Prude

• Family Medicine Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.